bluuebunny/crossref_metadata_2025 huggingface dataset:
Fatal hemolytic disease of the newborn due to anti‐B Isohemagglutinin: An unfamiliar presentation of a familiar disease
Authors: Longacre Mckenna , Bendapudi Pavan K.
Published: December 2023

Background

Hemolytic disease of the newborn (HDN) occurs in approximately 1 out of 3000 live births. Severe presentations are atypical but must be recognized and treated rapidly to avoid life‐threatening organ dysfunction.

Case Presentation

Here we report an unusual case of neonatal ABO HDN that illustrates the enormous inflammatory potential of maternal‐fetal blood group mismatch. Following an uneventful delivery notable only for HDN caused by maternal anti‐B IgG, our patient developed shock, DIC, and renal failure. Despite numerous interventions, she experienced a rapid clinical decline and died 10 days after birth. Treatment with whole blood exchange and a monoclonal antibody directed at complement component 5 (eculizumab) were attempted late in the disease course but were unsuccessful. Importantly, this patient had several known risk factors for severe ABO HDN, including the pentad of a group O mother with a group B neonate, high newborn red blood cell B antigen expression, presence maternal anti‐B isohemagglutinin in high titer, presence of a maternal IgG anti‐B isohemagglutinin, and African ancestry.

Conclusion

Clinicians should be aware of the potential for severe ABO HDN and consider earlier diagnostic workup and more aggressive therapy in patients with high‐risk features.
Efficacy of the topical antihistamine olopatadine in dogs with experimentally induced allergic conjunctivitis
Authors: Mamo Esther T. , Newbold Georgina M. , Moorehead Shelby C.
Published: December 2023

Objective

The objective of the study was to evaluate the efficacy of a once a day, over the counter antihistamine eye drop, 0.7% olopatadine hydrochloride, in treating or preventing experimentally induced allergic conjunctivitis in dogs.

Animals studied

Twelve systemically healthy pet dogs with no known history of allergies or atopic dermatitis, and in the past 12 months had no known ocular abnormalities.

Procedures

Dogs were randomly assigned to two groups: “Treatment” which received topical 0.7% olopatadine hydrochloride and “Control” which received artificial tears. Dogs received the antihistamine eye drops before (Phase 1) or after (Phase 2) receiving a compounded ophthalmic histamine solution to induce clinical signs of allergic conjunctivitis. Conjunctival hyperemia, chemosis, follicles, ocular discharge, and ocular pruritus were graded, and photographs were used to document changes. Schirmer tear test values, fluorescein staining, and intraocular pressures were monitored throughout.

Results

In both Phase 1 and Phase 2, conjunctival scores increased 10 min after histamine administration (p < .05). There was no difference between maximum overall conjunctival scores between treatment and control groups in either phase or when comparing treatment groups of Phase 1 to Phase 2 (p > .05). However, treatment groups in Phase 2 did have a higher maximum conjunctival chemosis score and spent more time at their maximum chemosis score when compared to Phase 1 (p < .05).

Conclusion

Olopatadine may be beneficial as prophylaxis to reduce the degree and duration of clinical signs of allergic conjunctivitis.
State-Level Politics and Bias Predict Transgender Athlete Bans
Authors: Garrison Kelsey M. , Cunningham George B.
Published: December 2023

The purpose of this study was to examine the relationships among the political leanings of a state, the state-level implicit and explicit biases against transgender people, and the presence of transgender athlete bans. The authors collected archival data from 2021 and 2022 bans in the United States to examine the hypotheses. As of 2022, 18 states had passed laws barring transgender athletes from participating in sports. Results from regression analyses showed that conservative-leaning states were more likely to enact transgender athlete bans than their peers. The relationship was mediated by explicit (but not implicit) bias toward transgender people. The findings have implications for research and practice. Sport managers have an opportunity to create transgender-inclusive workplaces for staff, coaches, and other managers. They should also work with campus counselors and other staff to ensure that transgender athletes have ample support.
SARS-CoV-2 in an immunocompromised host: convalescent plasma therapy and viral evolution elucidated by whole genome sequencing
Authors: Seth-Smith Helena , Vesenbeckh Silvan , Egli Adrian , Ott Sebastian
Published: December 2023

The evolution of SARS-CoV-2 within immunocompromised hosts who fail to clear the virus over many months has been proposed as a route to the development of Variants of Concern (VoCs). We present a case of an immunocompromised male patient with a prolonged SARS-CoV-2 infection. During hospitalisation, 7 weeks after first diagnosis, his condition worsened to require continuous ventilation support. Resolution of symptoms was observed after convalescent plasma therapy. Whole genome sequencing of the virus showed Pango lineage B.1.221. Between the first sample and the second from bronchoalveolar lavage fluid 7 weeks later, we identified eight mutations, including minor variants, which could be used to estimate the chronology of mutations. This suggests an elevated mutation rate, in-host accumulation of mutations and further evidence for sources of VoCs. Prolonged SARS-CoV-2 infections in immunocompromised hosts increase the likelihood of hospital stays and morbidity, and also pose an increased risk to global public health.
Cerebral near-infrared spectroscopy for early recognition of impending cardiac tamponade in a preterm neonate
Authors: Raets Marlou , Dirix Marc , Hütten Matthias Christian
Published: December 2023

Cardiac tamponade is a rare but life-threatening complication of umbilical venous catheter (UVC) placement in neonates. Mortality rates are high; therefore, early diagnosis is important. We present a case of a preterm infant with a UVC in situ who underwent a laparotomy on the first day of life for pneumoperitoneum secondary to meconium ileus. The operation was uneventful; however, 2 hours after surgery, the patient developed cardiac tamponade, requiring resuscitation and pericardiocentesis. In retrospect, near-infrared spectroscopy (NIRS) showed a gradual decline in cerebral oxygenation (crSO2) in the 30 min prior to the cardiac arrest, while other vital signs were within normal ranges. Our case demonstrates that cerebral NIRS monitoring can serve as an additional clinical marker for early recognition of impending cardiac tamponade.
Venous malformation phleboliths mimicking submandibular sialadenitis in children
Authors: Chrysouli Konstantina , Karamagkiolas Sotirios
Published: December 2023

To report one paediatric patient who presented with a rare venous vascular malformation as a mass in the left submandibular region with a clinical picture compatible with sialadenitis. Phleboliths are a specific feature of venous malformations due to venous stasis and may mimic sialoliths on various imaging modalities. Thus venous malformations are often misdiagnosed as sialadenitis due to sialolithiasis. Sialoliths are extremely rare in paediatric patients. In an early adolescent presenting with a submandibular mass and suspected sialadenitis arising from sialoliths, a detailed history, clinical examination and careful review of the radiological findings will allow the diagnosis of venous vascular malformation and provide the complete surgical resection. Our patient was initially referred with a presumed diagnosis of submandibular sialadenitis, and instead a venous malformation with phlebolith was diagnosed.
Trends in age of tobacco use initiation over time in Bangladesh, India and Pakistan: analysis of cross-sectional nationally representative surveys
Authors: Singh Lucky , Jain Pankhuri , Kumar Chandan , Singh Ankur , Lal Pranay , Yadav Amit , Singh Prashant Kumar , Singh Shalini
Published: December 2023

Objective

Tobacco use begins at an early age and typically leads to a long-term addiction. The age of initiation for tobacco use is not well studied in South Asia, where 22% of tobacco smokers and 81% of smokeless tobacco (SLT) users reside.

Methods

Data from the nationally representative Global Adult Tobacco Surveys in India, Bangladesh and Pakistan were analysed to examine patterns of initiation among smokers and smokeless tobacco users.

Results

Data on 94 651 individuals were analysed, of which 13 396 reported were ever daily smokers and 17 684 were ever SLT users. The proportion of individuals initiating tobacco use before the age of 15 years has increased over time. The rates of SLT initiation among those aged 15–24 years increased markedly in Bangladesh (by 7.8%) and Pakistan (by 37.7%) between 1983 and 1999–2000. Among males, the increase in SLT initiation was higher in individuals aged below 15 years compared with other age groups in India and Bangladesh. Smoking initiation among females aged below 15 years has also significantly increased in India over time. Compared with the initiation of tobacco smoking before the age of 15 years, a greater increase in the proportion of SLT users was observed in urban areas.

Conclusion

Our findings indicate that the proportion of youth initiating tobacco (both smoking and smokeless) before the age of 15 years has increased over time in all three countries. Moreover, variations in age at initiation for different types of tobacco products across countries, and by rurality, were noticeable. Younger youths (aged up to 15 years) should therefore be a priority population for tobacco control interventions. Strategies such as raising the legal age of tobacco sale and use to 21 years, and, other measures under WHO Framework Convention on Tobacco Control (FCTC), may prevent underage use and avert lifelong addiction to tobacco products.
Prevalence and risk factors of metabolic syndrome in Ethiopia: describing an emerging outbreak in HIV clinics of the sub-Saharan Africa – a cross-sectional study
Authors: Abdela Abdurezak Ahmed , Yifter Helen , Reja Ahmed , Shewaamare Aster , Ofotokun Ighovwerha , Degu Wondwossen Amogne
Published: December 2023

Objectives

HIV-induced chronic inflammation, immune activation and combination antiretroviral therapy (cART) are linked with adverse metabolic changes known to cause cardiovascular adversities. This study evaluates the prevalence of lipodystrophy, and metabolic syndrome (MetS), and analyses risk factors in HIV-infected Ethiopians taking cART.

Methods

A multicentre cross-sectional study was conducted at tertiary-level hospitals. Eligible participants attending the HIV clinics were enrolled. Sociodemographic, anthropometric, clinical, HIV treatment variables, lipid profile, fasting blood glucose level, risk factors and components of MetS, also lipodystrophy, were studied. Data were analysed by SPSS statistical package V.25 with descriptive and analytical statistics. For multivariable analysis of risk factors, a logistic regression model was used. Results were presented in frequency and percentages, mean±SD, or median+IQR. Statistical significance was taken as p<0.05.

Results

Among 518 studied participants, two-thirds were females, and the mean age of the study population was 45 years (SD=11). The mean duration of cART was 10 years (SD=4). Median CD4 count was 460 cells/mm3. The prevalence of MetS according to the Adult Treatment Panel III (2005) criteria was 37.6%. In multivariable analysis, independent risk factors for MetS were age >45 years (aHR 1.8, 95% CI 1.2 to 2.4), female sex (aHR 1.8, 95% CI 1.1 to 2.8), body mass index (BMI)>25 kg/m2(aHR 2.7, 95% CI 1.8 to 4.1), efavirenz-based cART (aHR 2.8, 95% CI 1.6 to 4.8) and lopinavir/ritonavir-based cART (aHR 3.7, 95% CI 1.0 to 13.3). The prevalence of lipodystrophy was 23.6%. Prior exposure to a stavudine-containing regimen was independently associated with lipodystrophy (aHR 3.1, 95% CI 1.6 to 6.1).

Conclusion

Our study revealed 38% of the participants had MetS indicating considerable cardiovascular disease (CVD) risks. Independent risk factors for MetS were BMI≥25 kg/m2, efavirenz and lopinavir/ritonavir-based cART, female sex and age ≥45 years. In addition to prevention, CVD risk stratification and management will reduce morbidity and mortality in people with HIV infection.
Does atrial fibrillation affect prognosis in hospitalised COVID-19 patients? A multicentre historical cohort study in the Netherlands
Authors: Spruit Jocelyn R , Jansen René W M M , de Groot Joris R , de Vries Tim A C , Hemels Martin E W , Douma Renee A , de Haan Lianne R , Brinkman Kees , Moeniralam Hazra S , de Kruif Martijn , Dormans Tom , Appelman Brent , Reidinga Auke C , Rusch Daisy , Gritters van den Oever Niels C , Schuurman Robert J , Beudel Martijn , Simsek Suat
Published: December 2023

Objectives

The aim of this multicentre COVID-PREDICT study (a nationwide observational cohort study that aims to better understand clinical course of COVID-19 and to predict which COVID-19 patients should receive which treatment and which type of care) was to determine the association between atrial fibrillation (AF) and mortality, intensive care unit (ICU) admission, complications and discharge destination in hospitalised COVID-19 patients.

Setting

Data from a historical cohort study in eight hospitals (both academic and non-academic) in the Netherlands between January 2020 and July 2021 were used in this study.

Participants

3064 hospitalised COVID-19 patients >18 years old.

Primary and secondary outcome measures

The primary outcome was the incidence of new-onset AF during hospitalisation. Secondary outcomes were the association between new-onset AF (vs prevalent or non-AF) and mortality, ICU admissions, complications and discharge destination, performed by univariable and multivariable logistic regression analyses.

Results

Of the 3064 included patients (60.6% men, median age: 65 years, IQR 55–75 years), 72 (2.3%) patients had prevalent AF and 164 (5.4%) patients developed new-onset AF during hospitalisation. Compared with patients without AF, patients with new-onset AF had a higher incidence of death (adjusted OR (aOR) 1.71, 95% CI 1.17 to 2.59) an ICU admission (aOR 5.45, 95% CI 3.90 to 7.61). Mortality was non-significantly different between patients with prevalent AF and those with new-onset AF (aOR 0.97, 95% CI 0.53 to 1.76). However, new-onset AF was associated with a higher incidence of ICU admission and complications compared with prevalent AF (OR 6.34, 95% CI 2.95 to 13.63, OR 3.04, 95% CI 1.67 to 5.55, respectively).

Conclusion

New-onset AF was associated with an increased incidence of death, ICU admission, complications and a lower chance to be discharged home. These effects were far less pronounced in patients with prevalent AF. Therefore, new-onset AF seems to represent a marker of disease severity, rather than a cause of adverse outcomes.
Cohort profile: evaluation of immune response and household transmission of SARS-CoV-2 in Costa Rica: the RESPIRA study
Authors: Loria Viviana , Aparicio Amada , Hildesheim Allan , Cortés Bernal , Barrientos Gloriana , Retana Daniela , Sun Kaiyuan , Ocampo Rebeca , Prevots D. Rebecca , Zúñiga Michael , Waterboer Tim , Wong-McClure Roy , Morera Melvin , Butt Julia , Binder Marco , Abdelnour Arturo , Calderón Alejandro , Gail Mitchell H , Pfeiffer Ruth M , Solís Cristina Barboza , Fantin Romain , Vanegas Juan Carlos , Mercado Rachel , Ávila Carlos , Porras Carolina , Herrero Rolando
Published: December 2023

Purpose

The RESPIRA cohort aims to describe the nature, magnitude, time course and efficacy of the immune response to SARS-CoV-2 infection and vaccination, population prevalence, and household transmission of COVID-19.

Participants

From November 2020, we selected age-stratified random samples of COVID-19 cases from Costa Rica confirmed by PCR. For each case, two population-based controls, matched on age, sex and census tract were recruited, supplemented with hospitalised cases and household contacts. Participants were interviewed and blood and saliva collected for antibodies and PCR tests. Participants will be followed for 2 years to assess antibody response and infection incidence.

Findings to date

Recruitment included 3860 individuals: 1150 COVID-19 cases, 1999 population controls and 719 household contacts from 304 index cases. The age and regional distribution of cases was as planned, including four age strata, 30% rural and 70% urban. The control cohort had similar sex, age and regional distribution as the cases according to the study design. Among the 1999 controls recruited, 6.8% reported at enrolment having had COVID-19 and an additional 12.5% had antibodies against SARS-CoV-2. Compliance with visits and specimens has been close to 70% during the first 18 months of follow-up. During the study, national vaccination was implemented and nearly 90% of our cohort participants were vaccinated during follow-up.

Future plans

RESPIRA will enable multiple analyses, including population prevalence of infection, clinical, behavioural, immunological and genetic risk factors for SARS-CoV-2 acquisition and severity, and determinants of household transmission. We are conducting retrospective and prospective assessment of antibody levels, their determinants and their protective efficacy after infection and vaccination, the impact of long-COVID and a series of ancillary studies. Follow-up continues with bimonthly saliva collection for PCR testing and biannual blood collection for immune response analyses. Follow-up will be completed in early 2024.

Trial registration number

NCT04537338.
Investigating trial design variability in trials of disease-modifying therapies in Parkinson’s disease: a scoping review protocol
Authors: Zeissler Marie-Louise , Boey Timothy , Chapman Danny , Rafaloff Gary , Dominey Thea , Raphael Karen G , Buff Susan , Pai Hari Venkatesh , King Emma , Sharpe Paul , O’Brien Fintan , Carroll Camille B
Published: December 2023

Introduction

Parkinson’s disease (PD) is a debilitating neurological disorder for which the identification of disease-modifying interventions represents a major unmet need. Diverse trial designs have attempted to mitigate challenges of population heterogeneity, efficacious symptomatic therapy and lack of outcome measures that are objective and sensitive to change in a disease modification setting. It is not clear whether consensus is emerging regarding trial design choices. Here, we report the protocol of a scoping review that will provide a contemporary update on trial design variability for disease-modifying interventions in PD.

Methods and analysis

The Population, Intervention, Comparator, Outcome and Study design (PICOS) framework will be used to structure the review, inform study selection and analysis. The databases MEDLINE, Web of Science, Cochrane and the trial registry ClinicalTrials.gov will be systematically searched to identify published studies and registry entries in English. Two independent reviewers will screen study titles, abstracts and full text for eligibility, with disagreements being resolved through discussion or by a third reviewer where necessary. Data on general study information, eligibility criteria, outcome measures, trial design, retention and statistically significant findings will be extracted into a standardised form. Extracted data will be presented in a descriptive analysis. We will report our findings using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review extension.

Ethics and dissemination

This work will provide an overview of variation and emerging trends in trial design choices for disease-modifying trials of PD. Due to the nature of this study, there are no ethical or safety considerations. We plan to publish our findings in a peer-reviewed journal.
Effect of whole-body cryotherapy versus placebo cryotherapy on joint pain induced by aromatase inhibitors in women with early stage breast cancer: a randomised clinical trial
Authors: Duraes Martha , Garbay Marion , Ferrer Catherine , Duflos Claire , Rathat Gauthier
Published: December 2023

Introduction

Hormone therapy (HT) is a major adjuvant treatment for breast cancer. Despite their effectiveness, aromatase inhibitors can cause several side effects, including arthralgia in 35%–50% of patients. These side effects frequently lead to the premature discontinuation of HT. Whole-body cryotherapy (WBC) can be used for managing arthritic pain. The primary objective of this study will be to evaluate the effect of WBC on aromatase-induced joint pain, compared with placebo cryotherapy, in patients with hormone-dependent breast cancer receiving adjuvant aromatase inhibitors. The secondary objectives will be to evaluate WBC safety and its effect on analgesic consumption, HT adherence and quality of life.

Methods and analysis

In this randomised, placebo-controlled, double-blinded clinical trial, 56 patients with aromatase inhibitor-induced joint pain and a Brief Pain Inventory-Short Form (BPI-SF) score ≥3 for the worst pain experienced in the previous week will be randomised into the WBC or placebo cryotherapy arm (10 sessions in each group). The primary outcome will be the BPI-SF score at week 6 post-treatment. The secondary outcomes will include the BPI-SF scores at months 3 and 6 post-treatment, the BPI-SF pain severity index and pain interference index, the Health Assessment Questionnaire score, the number of days of aromatase inhibitor treatment and analgesic consumption in the 15 days before the visits at week 6 and months 3 and 6 after cryotherapy. The incidence of adverse events will also be investigated.

Ethics and dissemination

Ethics approval was obtained from the Ethics Committee Est IV of Hospital Civil, Strasbourg, France. Protocol V.5 was approved in December 2022. The results will be disseminated in a peer-reviewed journal and presented at international congresses.

Trial registration number

NCT05315011.
Differentiating Alzheimer’s disease from mild cognitive impairment: a quick screening tool based on machine learning
Authors: Lü Wenqi , Zhang Meiwei , Yu Weihua , Kuang Weihong , Chen Lihua , Zhang Wenbo , Yu Juan , Lü Yang
Published: December 2023

Background

Alzheimer’s disease (AD) is a neurodegenerative disorder characterised by cognitive decline, behavioural and psychological symptoms of dementia (BPSD) and impairment of activities of daily living (ADL). Early differentiation of AD from mild cognitive impairment (MCI) is necessary.

Methods

A total of 458 patients newly diagnosed with AD and MCI were included. Eleven batteries were used to evaluate ADL, BPSD and cognitive function (ABC). Machine learning approaches including XGboost, classification and regression tree, Bayes, support vector machines and logical regression were used to build and verify the new tool.

Results

The Alzheimer’s Disease Assessment Scale (ADAS-cog) word recognition task showed the best importance in judging AD and MCI, followed by correct numbers of auditory verbal learning test delay recall and ADAS-cog orientation. We also provided a selected ABC-Scale that covered ADL, BPSD and cognitive function with an estimated completion time of 18 min. The sensitivity was improved in the four models.

Conclusion

The quick screen ABC-Scale covers three dimensions of ADL, BPSD and cognitive function with good efficiency in differentiating AD from MCI.
INvestigational Study Into Transplantation of the Uterus (INSITU): a cross-sectional survey among women with uterine factor infertility in the UK assessing background, motivations and suitability
Authors: Jones Benjamin P , Vali Saaliha , Kasaven Lorraine S , Mantrali Ifigenia , Saso Srdjan , Bracewell-Milnes Timothy , Nicopoullos James , Thum Meen-Yau , Diaz-Garcia Cesar , Quiroga Isabel , Yazbek Joseph , Smith James Richard
Published: December 2023

Importance

The study summarises the selection prescreen criteria currently used in the UK for a uterus transplant and highlights the number of women who are suitable to proceed.

Objectives

To assess the demographics, motivations, reasons and suitability among women with absolute uterine factor infertility (AUFI) to undergo uterine transplantation (UTx).

Design

A cross-sectional survey.

Setting

An electronic questionnaire was sent via email to women with AUFI who had previously been referred to the UTx research team or approached the Womb Transplant UK Charity. The questions assessed suitability to undergo UTx based on demographic information, perceptions to adoption and surrogacy and reasons why UTx was preferable. Responses were assessed against the study selection criteria.

Participants

Women with AUFI.

Results

210 women completed the questionnaire. The most common aetiology of AUFI in our cohort was Mayer-Rokitansky-Küster-Hauser (68%; n=143) whereas 29% (n=62) had previously undergone hysterectomy. 63% (n=132) of the cohort had previously considered adoption, 5% (n=11) had attempted it and 2 (1%) had successfully adopted. The most common reason cited to undergo UTx over adoption was to experience gestation (n=63; 53%), while 37% (n=44) wanted a biologically related child. 76% (n=160) of participants had previously considered surrogacy, 22 (10%) had attempted it and 2 (1%) had successfully become mothers using a surrogate. The most common reason to undergo UTx over surrogacy was to experience gestation (n=77; 54%). 15% (n=21) were concerned about the legal implications, 14% (n=20) identified the financial cost as a barrier and 8% (n=12) could not consider it due to religious reasons. On adhering to the selection criteria, 65 (31%) women were suitable to proceed with the trial.

Conclusion

The study demonstrates that implementing commonly used selection criteria for a UTx led to an attrition rate of more than two-thirds of women who requested to initially undergo the process. As more studies present outcomes following UTx, critical assessment of the selection criteria currently used is warranted to ensure potential recipients are not being unnecessarily excluded.

Trial registration number

NCT02388802.
Psychosocial interventions promoting personal recovery in people with schizophrenia: a scoping review protocol
Authors: Quistgaard Maria , Myklebust Oda Leonarda Pollestad , Aure Thomas , Austin Stephen Fitzgerald , Berring Lene Lauge , Vernal Ditte Lammers , Storebø Ole Jakob
Published: December 2023

Introduction

Personal recovery is an important aspect for many individuals diagnosed with schizophrenia, as people can live rich, fulfilling lives despite ongoing symptoms. Prior reviews have found several factors to be associated with personal recovery, but a comprehensive overview of the psychosocial interventions aimed at improving personal recovery in schizophrenia is needed.

Methods and analysis

Key terms relating to personal recovery and psychosocial interventions to promote personal recovery will be searched for in the following databases: PubMed, EMBASE, PsycINFO, CINAHL, MEDLINE, Google Scholar, Web of Science Core Collection and Cochrane. Additionally, a simple search for grey literature will be conducted in The Networked Digital Library of Theses and Dissertations. Two reviewers will individually screen and extract the data, and the selection of sources will be documented in a Preferred Reporting Items for Systematic reviews and Meta-Analyses flow chart. A content analysis will be conducted on the data, and the findings will be presented in tables, and narratively synthesised. Lastly, research gaps will be identified, and recommendations for future research will be proposed.

Ethics and dissemination

Ethics approval was not required for the development or publishing of this protocol. Findings will be disseminated through conferences, meeting with patient organisations and consumers, and published in a peer-reviewed scientific journal.
Non-pharmacological interventions in primary care to improve the quality of life of older patients with palliative care needs: a systematic review of randomised controlled trials
Authors: Seiça Cardoso Carlos , Rita Matos Joana , Prazeres Filipe , Gomes Barbara
Published: December 2023

Objectives

Our systematic review aimed to summarise non-pharmacological interventions applicable in primary care that improve the quality of life of older patients with palliative care needs.

Design

Systematic review.

Primary and secondary outcome measures

The primary outcome was patients’ quality of life. Secondary outcomes were symptoms relief and patients’ well-being measures.

Methods and analysis

We searched MEDLINE, EMBASE, PsycINFO, Cochrane and CINAHL up to October 2022 for randomised controlled trials (RCTs). We also handsearched abstract books of relevant congresses and scientific meetings in the last 5 years. Screening, data extraction and quality evaluation (Cochrane risk-of-bias (RoB) V.2.0 tool and Grading of Recommendations, Assessment, Development and Evaluations (GRADE)) were done independently by two reviewers, with disagreements solved by a third reviewer. Findings were narratively synthesised.

Results

We identified 4 RCTs, including 268 patients. One study used a broad criteria of palliative care needs (‘progressive, life-threatening disease’), two studies focused on advanced cancer and one study on heart failure. The non-pharmacological interventions evaluated were advance care planning conducted by general practitioners (GPs); social worker-aided palliative care; online primary palliative care training for GPs and spiritual history taking by nurses and GPs. No intervention showed a statistically significant impact on quality of life and the evidence was low according to GRADE.

Conclusion

The results highlight a dearth of evidence on what non-pharmacological interventions can be effectively done in primary care to improve the quality of life of older persons with palliative care needs. The results should be interpreted with caution, as the search more comprehensively covers interventions delivered by GPs.

PROSPERO registration number

CRD42020154216.
Effects of repetitive transcranial magnetic stimulation over the contralesional dorsal premotor cortex on upper limb function in severe ischaemic stroke: study protocol for a randomised controlled trial
Authors: Dai Wenjun , Yang Xi , Liu Canhuan , Ding Hongyuan , Guo Chuan , Zhu Yi , Dong Manyu , Qian Yilun , Fang Lu , Wang Tong , Shen Ying
Published: December 2023

Introduction

Repetitive transcranial magnetic stimulation (rTMS) is an evidence-based treatment widely recommended to promote hand motor recovery after ischaemic stroke. However, the therapeutic efficacy of rTMS over the motor cortex in stroke patients is currently restricted and heterogeneous. This study aimed to determine whether excitatory rTMS over the contralesional dorsal premotor cortex (cPMd) facilitates the functional recovery of the upper limbs during the postacute stage of severe ischaemic stroke.

Methods and analysis

This study will be conducted as a single-blind, controlled, randomised study, in which 44 patients with poststroke hemiplegia with a course of disease ranging from 1 week to 3 months and Fugl-Meyer upper limb score ≤22 will be enrolled. The study participants will be randomly assigned to groups A (n=22) and B (n=22). The two groups are based on routine rehabilitation training and drug treatment; group A will be treated with low-frequency (1 Hz) rTMS over the contralesional primary motor cortex (cM1), and group B will be treated with high-frequency (10 Hz) rTMS over cPMd. For 2 weeks, rTMS will be administered once a day, 5 days a week. The primary outcome is the Fugl-Meyer assessment of the upper limb. The secondary outcomes include the Arm Subscore of the Motricity Index, Hong Kong edition of Functional Test for the Hemiplegic Upper Extremity, Modified Barthel Index and Modified Ashworth Scale score of the paralysed pectoralis major and biceps brachii. Furthermore, data of diffusion tensor imaging and functional MRI will be collected. These outcomes will be assessed before and after the completion of the intervention.

Ethics and dissemination

This study has been approved by the Ethics Committee of the First Affiliated Hospital of Nanjing Medical University (2020 SR-266). The findings of this study will be spread through networks of scientists, professionals and the general public as well as peer-reviewed scientific papers and presentations at pertinent conferences.

Trial registration number

ChiCTR2000038049
Effects of the different intensities of task-oriented training on the upper extremity motor function and self-care ability of stroke survivors: study protocol for a multiarm parallel-group randomised controlled trial in a tertiary hospital in China
Authors: Liu Shengfeng , Zhang Kai , Li Xuecha , Li Chunxiang , Peng Mengsi
Published: December 2023

Introduction

Although task-oriented training (TOT) may provide added therapeutic value to stroke survivors, current TOT guidance offers insufficient advice on standardisation, particularly choices of intensity, for clinical practice. Therefore, this study aims to explore the effects of different intensities of TOT on motor function and self-care ability of stroke survivors.

Methods and analysis

This randomised controlled clinical trial will recruit 72 participants from a tertiary hospital, diagnosed with decreased self-care ability and upper limb motor dysfunction post-stroke. All participants will be randomly assigned to one of three experimental groups or the control group to undergo intervention for 8 weeks. The participants in the control group (n=18) will receive traditional occupational therapy, while those in the experimental groups will receive different intensities of TOT (50%, 75% and 100% intensity for groups A, B and C, respectively). This protocol designed a more innovative and optimised TOT programme to explore the optimal intensity of TOT on stroke survivors. The primary outcome is Canadian Occupational Performance Measure, and the secondary outcomes include Modified Barthel Index, Wolf Motor Function Test and Motor Activity Log.

Ethics and dissemination

The Second Affiliated Hospital of Hainan Medical University Ethics Committee approved the medical and ethical protocol for this study (LW2022015). All participants will sign an informed consent form. The results will be presented in scientific conferences and published in peer-reviewed journals.

Trial registration number

ChiCTR2200056390.
Self-reported prevalence of asthma and its associated factors among adult rural population in Bangladesh: a cross-sectional study using WHO PEN protocol
Authors: Rakhshanda Shagoofa , Abedin Minhazul , Wahab Abrar , Barua Lingkan , Faruque Mithila , Banik Palash Chandra , Shawon Riffat Ara , Rahman AKM Fazlur , Mashreky Saidur Rahman
Published: December 2023

Objective

For over a decade, the prevalence of asthma remained unchanged at around 7% in Bangladesh. Although asthma causes significant morbidity among both children and adults, updates on epidemiological data are limited on the prevalence in Bangladesh. This study attempted to determine the prevalence of asthma, and its modifiable and non-modifiable lifestyle predictors in a rural population of Bangladesh.

Method

This study was part of a cross-sectional study that applied the WHO Package of Essential Noncommunicable Disease Interventions via census in a rural area of Bangladesh, where self-reported data on asthma were recorded. Data on anthropometric measurement, sociodemographic characteristics and behavioural risk factors were collected following the standard protocol described in the WHO STEP-wise approach to surveillance (STEPS) questionnaire. Analysis included descriptive statistics to assess the prevalence of asthma and its risk factors, and binary logistic regression to determine contributing factors.

Result

The overall prevalence of asthma was 4.2%. Asthma was predominant among people above 60 years (8.4%). Higher asthma was noted among males (4.6%), self-employed (5.1%), with a family history of asthma (9.1%), with comorbidities besides asthma (7.8%) and underweight (6.0%) compared with their counterparts. The OR of having asthma was 1.89, 1.93, 1.32, 1.50, 2.60, 0.67, 0.67 and 0.78 if a respondent was 45 years old or more, married, underweight, ever smoker, with a family history of asthma, housewife, employed and consumed red meat, respectively, while considering all other variables constant, compared with their counterparts.

Conclusion

The study emphasised asthma to be a public health concern in Bangladesh, although it seems to have decreased over the last decade. Among others, red meat intake and nutritional status were strongly associated with asthma, and the linkage among these is still a grey area that needs further exploration.
Virtual reality as an adjunct to pulmonary rehabilitation of patients with chronic obstructive pulmonary disease: a protocol for systematic review and meta-analysis
Authors: Li Yi , Jiang Hongzhan , Lyu Zhi
Published: December 2023

Introduction

Chronic obstructive pulmonary disease (COPD) is a prevalent chronic lung disease characterised by persistent and progressive airflow obstruction resulting from tracheal and/or alveolar lesions. Patients afflicted with COPD endure a poor quality of life primarily due to the symptoms of the disease. Pulmonary rehabilitation (PR) constitutes a core component of the comprehensive management of individuals dealing with COPD. Nevertheless, suboptimal adherence and completion rates are the chief impediments associated with PR. Virtual reality (VR) is emerging as a promising approach to support patients with COPD in their PR journey. Currently, no comprehensive systematic review has evaluated the impact of VR as a PR adjunct in patients with COPD. We aimed to investigate and summarise the evidence from recent studies related to the effect of VR as an adjunct to PR in COPD cases.

Methods and analysis

We will conduct a comprehensive search of databases, including Web of Science, CINAHL, PubMed, Embase, Cochrane Central Register of Controlled Trials and ClinicalTrials.gov, from their inception up to May 2023 to identify randomised controlled trials examining VR as an adjunct to PR in patients with COPD, with no restrictions on publication status or language. Our primary outcome measure will be the 6-min walk test. Two independent researchers will screen the literature for suitable articles for inclusion in this meta-analysis. Data collection and assessment of bias risk will be performed. This meta-analysis is intended to furnish data on each outcome as sufficient data become available. Heterogeneity will be assessed using the χ2test and I2statistics. The current review will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Ethics and dissemination

Ethical approval is waived due to the retrospective nature of this study. Furthermore, the findings will be disseminated through peer-reviewed journals.

PROSPERO registration number

CRD42022374736.
Recommendations for the primary prevention of atherosclerotic cardiovascular disease in primary care: study protocol for a systematic guideline review
Authors: Schürmann Lara , Bredehorst Maren , González-González Ana I , Muth Christiane , van der Wardt Veronika , Puzhko Svetlana , Haasenritter Joerg
Published: December 2023

Introduction

Atherosclerotic cardiovascular disease (ASCVD) was the main cause of death in Germany in 2021, with major risk factors (ie, hypertension, diabetes, dyslipidaemia, obesity and certain lifestyle factors) being highly prevalent. Preventing ASCVD by assessment and modification of these risk factors is an important challenge for general practitioners. This study aims to systematically review and synthesise recent recommendations of national and international guidelines regarding the primary prevention of ASCVD in adults in primary care.

Methods and analysis

We will conduct a systematic review of clinical practice guidelines (CPGs) to evaluate primary prevention strategies for ASCVD. CPGs will be retrieved from MEDLINE and the Turning Research Into Practice database, guideline-specific databases and websites of guidelines-producing societies, with searches limited to publications from 2016 onwards. We will include CPGs in English, Spanish, German or Dutch languages that provide evidence-based recommendations for ASCVD prevention. The study population will include adults without diagnosed ASCVD. Two independent reviewers will assess guideline eligibility and quality by means of the mini-checklist MiChe, and extract study characteristics and relevant recommendations for further consistency analysis. A third reviewer will resolve disagreements. Findings will be presented as a narrative synthesis and in tabular form.

Ethics and dissemination

This review does not require ethical approval. Our systematic review will inform the CPG of the German College of General Practitioners and Family Physicians on the primary prevention of ASCVD. The review results will also be disseminated through publications in peer-reviewed journals and presentations at local, national and international conferences.

PROSPERO registration number

CRD42023394605.
Mhealth tools for community-based infectious disease surveillance in Africa: a scoping review protocol
Authors: Aku Fortress Yayra , Amuasi John Humphrey , Debrah Linda Batsa , Opoku Daniel , Gmanyami Jonathan Mawutor , Hoerauf Achim , Debrah Alexander Yaw , Quentin Wilm
Published: December 2023

Introduction

Countries in the WHO’s African region have found community-based surveillance useful in ensuring the effectiveness of the Integrated Disease Surveillance and Response strategy. This approach encourages community participation in the surveillance system, in addition to early detection of outbreaks and other health threats. Thus, advancements in mobile health have the potential to improve community-based surveillance in Africa. The purpose of this review is to map evidence on available mhealth tools for community-based infectious disease surveillance in Africa.

Methods and analysis

The scoping review will follow a mixed-methods approach in line with the framework of Arksey and O’Malley amended by Levac and colleagues and the Joanna Briggs Institute. To retrieve published literature, PubMed, Scopus, Web of Science, Google Scholar and Google databases will be explored. Websites of organisations involved in surveillance activities across the African region will also be explored. Authors will be interested in published literature between 2000 and 2022 in any language. The primary investigator and a second author will independently review the retrieved titles according to the inclusion criteria, while a third reviewer will resolve conflicts that may arise. The review will map evidence according to the key concepts (mhealth, community-based surveillance and Africa) to inform stakeholders and mhealth designers on best practices to adopt involving mhealth approaches at the community level and mhealth tool designs, respectively. Results following the review will be presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: Extension for Scoping Review Guidelines.

Ethics and dissemination

Ethical approval is not required for scoping reviews as it does not involve the use of human subjects. This review is the first phase in an overall project on digital health. The findings of the review will be published in a peer-reviewed journal and disseminated at suitable forums and conferences.
What do older people who have attempted suicide experience? Study protocol for a qualitative meta-synthesis among older adults, family caregivers and healthcare professionals
Authors: Sunzi Kejimu , Luo Hui , Li Yadi , Zhou Xin , Lei Cheng
Published: December 2023

Introduction

Attempted suicide among older adults represents a significant mental health concern that has witnessed a rising incidence within this demographic in recent years. Research indicates that attempted suicide among the older population serves as a primary risk factor for completed suicide. Consequently, the objective of this study is to provide a comprehensive overview of the prevailing factors that influence suicide attempts among older adults, thereby offering evidence to guide healthcare professionals in designing targeted interventions.

Methods and analysis

This study will adhere to the Joanna Briggs Institute framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. We will synthesise qualitative studies using a comprehensive and inclusive bibliographic search strategy. The following databases will be searched: PubMed, Embase, Web of Science, CINAHL and the Cochrane Library. The quality of the articles will be assessed using the 10-item Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. At the same time, data extraction will be performed using the Qualitative Assessment and Review Instrument data extraction form proposed by the Joanna Briggs Institute for Evidence-Based Practice. The synthesis of findings will adhere to the principles and procedures of Thomas and Hardens' three-stage thematic synthesis approach.

Ethics and dissemination

Ethical approval will not be required for this study, as it solely encompasses data derived from previously published research. The findings will be disseminated through publication in a peer-reviewed journal. Moreover, the results will be presented at relevant academic conferences to guarantee that the study’s outcomes reach pertinent stakeholders. This protocol is registered with the PROSPERO prospective database for systematic review.

PROSPERO registration number

CRD42023408385.
Protocol for a prospective cohort study on the feasibility of application of nutritional ultrasound in the diagnosis and follow-up of patients with nutritional risk at hospital discharge: study on body composition and function (DRECO)
Authors: García Almeida José Manuel , Bellido Diego , De Luis Daniel , Guzmán Rolo Germán , Olveira Gabriel
Published: December 2023

Introduction

Nutritional ultrasound (US) is an emerging technique in clinical nutrition for the morphological and structural study of muscle mass. Currently, all definitions of malnutrition include the measurement of muscle mass; however, there is no single way to assess it. It is necessary to develop new techniques to identify muscle involvement in malnutrition that are valid, standardised, reliable, accurate and profitable.

Objective

To value the new muscle US techniques aimed to measure muscle and functional status, to make a more accurate diagnosis and a better prediction of complications and morbidity and mortality in patients at nutritional risk. Primary outcome: to assess the feasibility of US or muscle US techniques in both nutritional diagnosis and follow-up in a nutritional intervention programme.

Methods and analysis

Disease-Related caloric-protein malnutrition EChOgraphy (DRECO) is a prospective, multicentre (25 Spanish hospitals), uncontrolled clinical study in standard clinical practice to value the usefulness of nutritional US (muscle US) in the nutritional diagnosis and follow-up, over 3–6 months, after standard nutritional clinical practice intervention and physical activity, to control their disease-related malnutrition. 1000 patients are expected to be included in.

Discussion

This study will standardise nutritional US measures. It will validate and define specific cut-off values for nutritional US and correlate it with already well-known nutritional tools such as Subjective Global Assessment or Global Leadership Initiative on Malnutrition criteria. Thus, muscle US will become not only a tool to diagnose malnutrition, but it will also be integrated in the daily practice to evaluate nutritional interventions.

Ethics and dissemination

All DRECO study materials have been approved by each of the IRB/IEC of all the sites enrolled (either approval of the own IRB/IEC or validating the approval of the IRB/IEC of another hospital). The study has been registered with ClinicalTrials.gov, on 27 June 2022. The results from this study will be presented at scientific conferences and in peer-reviewed scientific journals.

Trial registration number

NCT05433831.