bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence of SARS-CoV-2 reinfection in a paediatric cohort in Kuwait
Authors: Alhaddad Fatemah , Abdulkareem Ali , Alsharrah Danah , Alkandari Abdullah , Bin-Hasan Saadoun , Al-Ahmad Mona , Al Hashemi Hashem , Alghounaim Mohammad 
Published: June 2022

ObjectiveSubsequent protection from SARS-CoV-2 infection in paediatrics is not well reported in the literature. We aimed to describe the clinical characteristics and dynamics of SARS-CoV-2 PCR repositivity in children.DesignThis is a population-level retrospective cohort study.SettingPatients were identified through multiple national-level electronic COVID-19 databases that cover all primary, secondary and tertiary centres in Kuwait.ParticipantsThe study included children 12 years and younger between 28 February 2020 and 6 March 2021. SARS-CoV-2 reinfection was defined as having two or more positive SARS-CoV-2 PCR tests done on a respiratory sample, at least 45 days apart. Clinical data were obtained from the Pediatric COVID-19 Registry in Kuwait.Primary and secondary outcome measuresThe primary measure is to estimate SARS-CoV-2 PCR repositivity rate. The secondary objective was to establish average duration between first and subsequent SARS-CoV-2 infection. Descriptive statistics were used to present clinical data for each infection episode. Also, incidence-sensitivity analysis was performed to evaluate 60-day and 90-day PCR repositivity intervals.ResultsThirty paediatric patients with COVID-19 had SARS-CoV-2 reinfection at an incidence of 1.02 (95% CI 0.71 to 1.45) infection per 100 000 person-days and a median time to reinfection of 83 (IQR 62–128.75) days. The incidence of reinfection decreased to 0.78 (95% CI 0.52 to 1.17) and 0.47 (95% CI 0.28 to 0.79) per person-day when the minimum interval between PCR repositivity was increased to 60 and 90 days, respectively. The mean age of reinfected subjects was 8.5 (IQR 3.7–10.3) years and the majority (70%) were girls. Most children (55.2%) had asymptomatic reinfection. Fever was the most common presentation in symptomatic patients. One immunocompromised experienced two reinfection episodes.ConclusionSARS-CoV-2 reinfection is uncommon in children. Previous confirmed COVID-19 in children seems to result in a milder reinfection.
Fluoxetine for reducing postoperative cognitive dysfunction in elderly patients after total knee replacement: study protocol for a single-centre, double-blind, randomised, parallel-group, superiority, placebo-controlled trial
Authors: Lin Daoyi , Yu Lulu , Chen Jiaxin , Ye Hong , Wu Yushan , Yao Yusheng 
Published: June 2022

IntroductionPostoperative cognitive dysfunction (POCD) is a common complication following major surgical procedures. The underlying pathophysiology is poorly understood, but the role of neuroinflammation is strongly implicated. Given the antineuroinflammatory and neuroprotective effects of fluoxetine, we hypothesise that fluoxetine may reduce the cumulative incidence of POCD in elderly patients undergoing total knee arthroplasty (TKA).Methods and analysisThis is a prospective, randomised, double-blind, parallel-group, placebo-controlled, superiority trial. Five hundred elderly patients undergoing unilateral TKA will be randomly assigned to the fluoxetine and placebo groups. The fluoxetine group will receive fluoxetine 20 mg daily 8 weeks preoperatively, and the placebo group will receive placebo capsules daily 8 weeks preoperatively. The primary outcome is the cumulative incidence of POCD at 1 month postoperatively. The secondary outcomes include the occurrence of delirium, the area under the curve of the Numeric Rating Scale pain scores over time, and sleep disturbance. Data on all the results, risk factors and adverse events will also be collected and analysed.Ethics and disseminationThe Fujian Provincial Hospital Ethics Board has approved the protocol for this trial (identifier number: K2021-01-009). All participants will be required to provide written informed consent before any protocol-specific procedures.Trial registration numberChiCTR2100050424.
Feasibility study of a randomised controlled trial of preoperative and postoperative nutritional supplementation in major lung surgery
Authors: Kerr Amy , Lugg Sebastian T , Kadiri Salma , Swift Amelia , Efstathiou Nikolaos , Kholia Krishna , Rogers Venessa , Fallouh Hazem , Steyn Richard , Bishay Ehab , Kalkat Maninder , Naidu Babu 
Published: June 2022

ObjectivesMalnutrition and weight loss are important risk factors for complications after lung surgery. However, it is uncertain whether modifying or optimising perioperative nutritional state with oral supplements results in a reduction in malnutrition, complications or quality of life.DesignA randomised, open label, controlled feasibility study was conducted to assess the feasibility of carrying out a large multicentre randomised trial of nutritional intervention. The intervention involved preoperative carbohydrate-loading drinks (4×200 mL evening before surgery and 2×200 mL the morning of surgery) and early postoperative nutritional protein supplement drinks two times per day for 14 days compared with the control group receiving an equivalent volume of water.SettingSingle adult thoracic centre in the UK.ParticipantsAll adult patients admitted for major lung surgery. Patients were included if were able to take nutritional drinks prior to surgery and give written informed consent. Patients were excluded if they were likely unable to complete the study questionnaires, they had a body mass index <18.5 kg/m2, were receiving parenteral nutrition or known pregnancy.ResultsAll patients presenting for major lung surgery were screened over a 6-month period, with 163 patients screened, 99 excluded and 64 (41%) patients randomised. Feasibility criteria were met and the study completed recruitment 5 months ahead of target. The two groups were well balanced and tools used to measure outcomes were robust. Compliance with nutritional drinks was 97% preoperatively and 89% postoperatively; 89% of the questionnaires at 3 months were returned fully completed. The qualitative interviews demonstrated that the trial and the intervention were acceptable to patients. Patients felt the questionnaires captured their experience of recovery from surgery well.ConclusionA large multicentre randomised controlled trial of nutritional intervention in major lung surgery is feasible and required to test clinical efficacy in improving outcomes after surgery.Trial registration numberISRCTN16535341.
Antipsychotic prescribing practices and patient, family member and healthcare professional perceptions of antipsychotic prescribing in acute care settings: a scoping review protocol
Authors: Jaworska Natalia , Moss Stephana Julia , Krewulak Karla D , Stelfox Zara , Niven Daniel , Ismail Zahinoor , Burry Lisa , Fiest Kirsten 
Published: June 2022

IntroductionAntipsychotic medications are commonly prescribed off-label in acutely ill patients for non-psychiatric clinical indications such as delirium or insomnia. New prescription initiation of antipsychotics in acute care settings increases the proportion of patients discharged home on antipsychotics without approved clinical indication. Long-term use of antipsychotics is associated with increased risk of sudden cardiac death, falls and cognitive impairment. An understanding of acute care off-label antipsychotic prescribing practices and healthcare professional, patient and family perceptions related to antipsychotic prescribing and deprescribing is necessary to facilitate in-hospital deprescribing initiatives.Methods and analysisWe present the protocol for a scoping review following the methodology proposed by Arksey and O’Malley and the Scoping Review Methods Manual by the Joanna Briggs Institute. We will search five databases including MEDLINE, EMBASE, CINAHL, PsycINFO and Web of Science from inception to 3 July 2021 (ie, planned search date). We will include both peer-reviewed and non-peer-reviewed qualitative and quantitative studies to identify antipsychotic prescribing practices, and to describe healthcare professional, patient and family perceptions towards antipsychotic prescribing and deprescribing in the acute care setting. Protocols, systematic and scoping reviews will be excluded. Two reviewers will calibrate and perform study screening and data abstraction for quantitative and qualitative outcomes of eligible studies. Quantitative outcomes will include study identifiers, demographics and descriptive statistics of antipsychotic prescribing practices. Qualitative synthesis describing perceptions on antipsychotic prescribing practices will include deductive thematic analysis with mapping of themes to the domains of the Theoretical Domains Framework, a 14-domain behaviour and behaviour change framework.Ethics and disseminationNo ethical approval will be required for this study as only data from published studies in which informed consent was obtained by primary investigators will be retrieved and analysed. The results of this scoping review will inform integrated knowledge translation initiatives aimed at in-hospital antipsychotic medication deprescribing.
Experiences of and response to the COVID-19 pandemic at private retail pharmacies in Kenya: a mixed-methods study
Authors: Mugo Peter Mwangi , Mumbi Audrey , Munene Daniella , Nzinga Jacinta , Molyneux Sassy , Barasa Edwine 
Published: June 2022

ObjectivesTo assess experiences of and response to the COVID-19 pandemic at community pharmacies in Kenya.Design, setting and participantsThis was a mixed-methods study conducted from November 2020 to April 2021, targeting service providers in three counties (Nairobi, Mombasa and Kisumu), selected purposively to represent the main urban centres; pharmacies were selected randomly from a list of licensed pharmacies.ResultsOf 195 sampled pharmacies, 108 (55%) completed a questionnaire and 103 (53%) received a simulated client call; 18 service providers were interviewed. The initial weeks of the pandemic were characterised by fear and panic among service providers and a surge in client flow. Subsequently, 65 (60%) of 108 pharmacies experienced a dip in demand to below prepandemic levels and 34 (31%) reported challenges with unavailability, high price and poor quality of products. Almost all pharmacies were actively providing preventive materials and therapies; educating clients on prevention measures; counselling anxious clients; and handling and referring suspect cases. Fifty-nine pharmacies (55% (95% CI 45% to 65%)) reported receiving a client asking for COVID-19 testing and a similar proportion stated they would support pharmacy-based testing if implemented. For treatment of simulated clients, most pharmacies (71%, 73 of 103) recommended alternative therapies and nutritional supplements such as vitamin C; the rest recommended conventional therapies such as antibiotics. While 52 (48%) of 108 pharmacies had at least one staff member trained on COVID-19, a general feeling of disconnection from the national programme prevailed.ConclusionsPrivate pharmacies in Kenya were actively contributing to the COVID-19 response, but more deliberate engagement, support and linkages are required. Notably, there is an urgent need to develop guidelines for pharmacy-based COVID-19 testing, a service that is clearly needed and which could greatly increase test coverage. Pharmacy-based COVID-19 programmes should be accompanied with implementation research to inform current and future pandemic responses.
Psychological experience of inpatients with acute pancreatitis: a qualitative study
Authors: Ma Shuli , Yang Xiaoxi , He Hongmei , Gao Yiwen , Chen Yuanyuan , Qin Jingwen , Zhang Can , Lu Guotao , Gong Weijuan , Chen Weiwei , Ren Yan 
Published: June 2022

ObjectiveThis study aimed to better understand the psychological experiences of inpatients with acute pancreatitis (AP).DesignWe used a qualitative descriptive study design to capture patients with AP’s thoughts, feelings and behavioural responses.SettingWe conducted this study in the gastroenterology departments of two tertiary hospitals in Eastern China.ParticipantsWe used a convenience sampling approach to recruit 28 inpatients with AP from 1 August 2020 to 25 December 2020. The interviews were audio-recorded and transcribed verbatim. We employed an adapted version of Colaizzi’s qualitative analysis approach to examine the data.ResultsWe extracted three themes and eight subthemes regarding the participants’ psychological experiences: (1) feeling that their disease is unpredictable (the inability to recognise the disease, uncertainty about the illness and fear of progression or recurrence); (2) various kinds of stress and support (feeling different degrees of stress, perceiving social support, seeking and craving social support); and (3) developing self-adaptability in the disease process (treating one’s illness negatively or positively).ConclusionsCognitive and emotional responses vary in patients with AP during hospitalisation. Moreover, patients with distinct conditions demonstrate significant differences in their responses and coping mechanisms. Healthcare providers need to mobilise social support and formulate comprehensive intervention strategies according to patients’ individual characteristics.
The analysis of risk factors for diabetic kidney disease progression: a single-centre and cross-sectional experiment in Shanghai
Authors: Liu Wen , Du Juan , Ge Xiaoxu , Jiang Xiaohong , Peng Wenfang , Zhao Nan , Shen Lisha , Xia Lili , Hu Fan , Huang Shan 
Published: June 2022

ObjectiveTo identify the risk factors for diabetic kidney disease (DKD) development, especially the difference between patients with different courses.Patients and methods791 patients were considered to be eligible and were enrolled in the cross-sectional study from Shanghai Tongren Hospital Inpatient Department. 36 variables were initially screened by univariate analysis. The risk factors affecting progression of DKD were determined by logistics regression analysis. Subgroups were grouped according to the course of diabetes disease, and multivariate logistics regression analysis was performed to find out the different risk factors in two subgroups. Finally, the receiver operating characteristics curve is used to verify the result.ResultsThe logistic regression model indicated age (OR=1.020, p=0.017, 95% CI 1.004 to 1.040), systolic blood pressure (OR=1.013, p=0.006, 95% CI 1.004 to 1.022), waist circumference (OR=1.021, p=0.015, 95% CI 1.004 to 1.038), white blood cells (WBC, OR=1.185, p=0.001, 95% CI 1.085 to 1.295) and triglycerides (TG, OR=1.110, p=0.047, 95% CI 1.001 to 1.230) were risk factors for DKD, while free triiodothyronine (fT3, OR=0.711, p=0.011, 95% CI 0.547 to 0.926) was a protective factor for DKD in patients with type 2 diabetes mellitus (T2DM). Subgroup analysis revealed that in patients with a short duration of diabetes (<8 years), WBC (OR=1.306, p<0.001, 95% CI 1.157 to 1.475) and TG (OR=1.188, p=0.033, 95% CI 1.014 to 1.393) were risk factors for DKD,fT3 (OR=0.544, p=0.002, 95% CI 0.367 to 0.804) was a protective factor for DKD; whereas for patients with disease course more than 8 years, age (OR=1.026, Pp=0.012, 95%CI=95% CI[ 1.006– to 1.048]) was identified as the only risk factor for DKD and fT3 (OR=0.036, Pp=0.017, 95%CI=95% CI[ 0.439– to 0.922]) was a protective factor for DKD.ConclusionThe focus of attention should especially be on patients with a prolonged course of T2DM, and those with comorbid hypertension and hypertriglyceridaemia waist phenotype. More potential clinical indexes such as thyroid function and inflammatory indicators might be considered as early warning factors for DKD in T2DM. Women should pay attention to controlling inflammation and TGs, and men should strictly control blood pressure. Avoiding abdominal obesity in both men and women will bring great benefits.
Scoping review of costs of implementation strategies in community, public health and healthcare settings
Authors: Michaud Tzeyu L , Pereira Emiliane , Porter Gwenndolyn , Golden Caitlin , Hill Jennie , Kim Jungyoon , Wang Hongmei , Schmidt Cindy , Estabrooks Paul A 
Published: June 2022

ObjectivesTo identify existing evidence concerning the cost of dissemination and implementation (D&I) strategies in community, public health and health service research, mapped with the ‘Expert Recommendations for Implementing Change’ (ERIC) taxonomy.DesignScoping review.Data sourcesMEDLINE, EMBASE, CINAHL, PsycINFO, Scopus and the Cochrane Library were searched to identify any English language reports that had been published between January 2008 and December 2019 concerning the cost of D&I strategies.Data extractionWe matched the strategies identified in each article using ERIC taxonomies; further classified them into five areas (eg, dissemination, implementation, integration, capacity building and scale-up); and extracted the corresponding costs (total costs and cots per action target and per evidence-based programme (EBP) participant). We also recorded the reported level of costing methodology used for cost assessment of D&I strategies.ResultsOf the 6445 articles identified, 52 studies were eligible for data extraction. Lack of D&I strategy cost data was the predominant reason (55% of the excluded studies) for study exclusion. Predominant topic, setting, country and research design in the included studies were mental health (19%), primary care settings (44%), the US (35%) and observational (42%). Thirty-five (67%) studies used multicomponent D&I strategies (ranging from two to five discrete strategies). The most frequently applied strategies were Conduct ongoing training (50%) and Conduct educational meetings (23%). Adoption (42%) and reach (27%) were the two most frequently assessed outcomes. The overall costs of Conduct ongoing training ranged from $199 to $105 772 ($1–$13 973 per action target and $0.02–$412 per EBP participant); whereas the cost of Conduct educational meetings ranged from $987 to $1.1–$2.9 million/year ($33–$54 869 per action target and $0.2–$146 per EBP participant). The wide range of costs was due to the varying scales of the studies, intended audiences/diseases and the complexities of the strategy components. Most studies presented limited information on costing methodology, making interpretation difficult.ConclusionsThe quantity of published D&I strategy cost analyses is increasing, yet guidance on conducting and reporting of D&I strategy cost analysis is necessary to facilitate and promote the application of comparative economic evaluation in the field of D&I research.
Cancer risk and tumour spectrum in 172 patients with a germlineSUFUpathogenic variation: a collaborative study of the SIOPE Host Genome Working Group
Authors: Guerrini-Rousseau Léa , Masliah-Planchon Julien , Waszak Sebastian M , Alhopuro Pia , Benusiglio Patrick R , Bourdeaut Franck , Brecht Ines B , Del Baldo Giada , Dhanda Sandeep Kumar , Garrè Maria Luisa , Gidding Corrie E M , Hirsch Steffen , Hoarau Pauline , Jorgensen Mette , Kratz Christian , Lafay-Cousin Lucie , Mastronuzzi Angela , Pastorino Lorenza , Pfister Stefan M , Schroeder Christopher , Smith Miriam Jane , Vahteristo Pia , Vibert Roseline , Vilain Catheline , Waespe Nicolas , Winship Ingrid M , Evans D Gareth , Brugieres Laurence 
Published: June 2022

BackgroundLittle is known about risks associated with germlineSUFUpathogenic variants (PVs) known as a cancer predisposition syndrome.MethodsTo study tumour risks, we have analysed data of a large cohort of 45 unpublished patients with a germlineSUFUPV completed with 127 previously published patients. To reduce the ascertainment bias due to index patient selection, the risk of tumours was evaluated in relatives withSUFUPV (89 patients) using the Nelson-Aalen estimator.ResultsOverall, 117/172 (68%)SUFUPV carriers developed at least one tumour: medulloblastoma (MB) (86 patients), basal cell carcinoma (BCC) (25 patients), meningioma (20 patients) and gonadal tumours (11 patients). Thirty-three of them (28%) had multiple tumours. Median age at diagnosis of MB, gonadal tumour, first BCC and first meningioma were 1.5, 14, 40 and 44 years, respectively. Follow-up data were available for 160 patients (137 remained alive and 23 died). The cumulative incidence of tumours in relatives was 14.4% (95% CI 6.8 to 21.4), 18.2% (95% CI 9.7 to 25.9) and 44.1% (95% CI 29.7 to 55.5) at the age of 5, 20 and 50 years, respectively. The cumulative risk of an MB, gonadal tumour, BCC and meningioma at age 50 years was: 13.3% (95% CI 6 to 20.1), 4.6% (95% CI 0 to 9.7), 28.5% (95% CI 13.4 to 40.9) and 5.2% (95% CI 0 to 12), respectively. Sixty-four different PVs were reported across the entireSUFUgene and inherited in 73% of cases in which inheritance could be evaluated.ConclusionGermlineSUFUPV carriers have a life-long increased risk of tumours with a spectrum dominated by MB before the age of 5, gonadal tumours during adolescence and BCC and meningioma in adulthood, justifying fine-tuned surveillance programmes.
Ultrasound-guided superficial cervical plexus block reduces opioid consumption in patients undergoing craniotomy via suboccipital retrosigmoid approach: a randomized controlled trial
Authors: Zeng Min , Li Ruowen , Xu Xin , Wang Dexiang , Dong Jia , Li Shu , Kass Ira S , Peng Yuming , Jia Wang 
Published: June 2022

IntroductionThe effectiveness of superficial cervical plexus block (SCPB) at decreasing opioid use and improving hemodynamic stability during suboccipital retrosigmoid craniotomy has not been established. The aim of this study is to evaluate the analgesic effect of preoperative ultrasound-guided SCPB for craniotomy via a suboccipital retrosigmoid approach.MethodsThis was a prospective, single-center, randomized, double-blind, parallel-group controlled trial. One hundred and six adult patients undergoing suboccipital retrosigmoid craniotomy were randomly allocated into either the SCPB group (n=53) to receive 10 mL of 0.5% ropivacaine or the control group (n=53) to receive 0.9% normal saline injected into the superficial layer of prevertebral fascia guided by ultrasound. The primary outcome was the cumulative consumption of sufentanil with patient-controlled intravenous analgesia (PCIA) within 24 hours. Secondary outcomes included the overall perioperative consumption of opioids, the area under the curve of the pain score from 1 hour to 48 hours (AUC1–48), intraoperative hemodynamic parameters, and anesthesia depth.ResultsThe mean PCIA pump cumulative consumption of sufentanil in the first 24 hour postoperative period was significantly lowered by SCPB (5.0 µg vs 9.8 µg, 95% CI: −8.0 to –2.4; p=0.001). The total perioperative consumption of sufentanil (45.0 µg vs 54.5 µg, 95% CI: –14.8 to –4.1; p=0.001) was also significantly decreased by SCPB. The incidence of severe pain within 24 hours was decreased by SCPB (7.5% vs 26.4%, p=0.01). SCPB significantly decreased the AUC1–48of the pain score. Intraoperative hemodynamic parameters and anesthesia depth were similar between groups (p>0.05).DiscussionSCPB provides effective analgesia in patients undergoing craniotomy and tumor resection via suboccipital retrosigmoid approach. SCPB demonstrates an opioid-sparing effect and allows for the maintenance hemodynamic stability at an appropriate depth of anesthesia.Trial registration numberNCT04036812.