bluuebunny/crossref_metadata_2025 huggingface dataset:
Coping with cancer pain: a qualitative study to explore pain perception and self-coping strategies of patients with cancer in Sri Lanka
Authors: Edirisinghe N P , Makuloluwa P T R , Amarasekara Thamara , Goonewardena C S E
Published: November 2024

Pain is one of the most debilitating symptoms of cancer, substantially diminishing one’s quality of life. The level of pain experienced is eventually determined by the pain coping strategies adopted by patients individually. The awareness of the ‘self-coping methods of pain’ of individual patients would be beneficial for the multidisciplinary pain team to consider such methods when planning future interventions to manage pain.

Objectives

This study explores the pain perception and coping strategies used by patients with cancer pain in Sri Lanka.

Design

A descriptive qualitative study.

Setting

Pain management unit, Apeksha Hospital, Maharagama, Sri Lanka.

Participants

The study was conducted among purposively selected patients with cancer and registered at the pain management unit. 21 semi-structured interviews were conducted until data saturation. Data were analysed using Graneheim and Lundman’s content analysis method.

Results

Most participants were between 51 and 60 years old and identified as Sinhalese Buddhists. The study’s findings revealed two subthemes under ‘Understanding pain’, namely ‘Physical and emotional impact’ and ‘Cultural and spiritual interpretations’, and five subthemes under ‘Coping strategies for living with pain’, namely ‘Medication and self-control’, ‘Seeking spiritual support’, ‘Receiving social support’, ‘Exploring alternative treatments’ and ‘Adapting daily life’.

Conclusion

Coping strategies were adopted especially in achieving essential life aspirations and participating in preferred activities. Goals or activities were often adjusted to fall within their health limits. Acceptance and progress in life were considered more important than pain control. We recommend giving due consideration to the ‘self-coping strategies’ of individual patients in designing interventions to mitigate cancer pain.
Efficacy and safety of remimazolam tosylate for patients undergoing off-pump coronary artery bypass grafting: a study protocol for a non-inferiority randomised controlled trial in China
Authors: Wang Dan , Cui Min , Wu Xue , Niu Min , Yu Tianhao , Zhang Yuzhu , Yue Yifeng , Wang Qingting , Xu Boxuan , Feng Nianhai , Si Jiguo
Published: November 2024

Introduction

Maintaining haemodynamic stability is crucial but challenging during the induction and maintenance of general anaesthesia (GA) in patients undergoing off-pump coronary artery bypass grafting (OPCABG). Remimazolam tosylate is a novel ultra-short-acting benzodiazepine with minimal cardiovascular depression. Currently, non-inferior studies comparing the haemodynamic changes induced by remimazolam and etomidate are limited. This study aims to assess the efficacy and safety of remimazolam tosylate for the induction and maintenance of GA in patients undergoing OPCABG.

Method and analysis

This two-armed non-inferiority randomised controlled trial will include 88 patients aged 18–75 years who are scheduled for OPCABG. Patients will be randomly assigned in a 1:1 ratio to receive either remimazolam tosylate or etomidate and propofol for anaesthesia induction and maintenance. The primary outcome will be the fluctuation of mean artery pressure during anaesthesia induction. Secondary outcomes will include adverse events, adverse drug reactions, the cumulative dosage of vasoactive drugs, vital signs and bispectral index values at different time points, lengths of postoperative mechanical ventilation and tracheal intubation, lengths of intensive care unit stay and hospital stay and hospital mortality. Analyses will be conducted using both the intention-to-treat approach and the per-protocol approach.

Ethics and dissemination

This study was approved by the Ethics Committee of Zibo Central Hospital (No. 2024001). The trial results will be submitted to an international peer-reviewed journal.

Trial registration number

ChiCTR.gov.cn: ChiCTR2400079615.
Nomogram model for predicting medication adherence in patients with various mental disorders based on the Dryad database
Authors: Pei Xiaoxian , Du Xiangdong , Liu Dan , Li Xiaowei , Wu Yajuan
Published: November 2024

Objective

Treatment compliance among psychiatric patients is related to disease outcomes. How to assess patient compliance remains a concern. Here, we established a predictive model for medication compliance in patients with psychotic disorders to provide a reference for early intervention in treatment non-compliance behaviour.

Design

Clinical information for 451 patients with psychotic disorders was downloaded from the Dryad database. The Least Absolute Shrinkage and Selection Operator regression and logistic regression were used to establish the model. Bootstrap resampling (1000 iterations) was used for internal validation and a nomogram was drawn to predict medication compliance. The consistency index, Brier score, receiver operating characteristic curve and decision curve were used for model evaluation.

Setting

35 Italian Community Psychiatric Services.

Participants

451 patients prescribed with any long-acting intramuscular (LAI) antipsychotic were consecutively recruited, and assessed after 6 months and 12 months, from December 2015 to May 2017.

Results

432 patients with psychotic disorders were included for model construction; among these, the compliance rate was 61.3%. The Drug Attitude Inventory-10 (DAI-10) and Brief Psychiatric Rating Scale (BPRS) scores, multiple hospitalisations in 1 year and a history of long-acting injectables were found to be independent risk factors for treatment noncompliance (all p<0.01). The concordance statistic of the nomogram was 0.709 (95% CI 0.652 to 0.766), the Brier index was 0.215 and the area under the ROC curve was 0.716 (95% CI 0.669 to 0.763); decision curve analysis showed that applying this model between the threshold probabilities of 44% and 63% improved the net clinical benefit.

Conclusion

A low DAI-10 score, a high BPRS score, multiple hospitalisations in 1 year and the previous use of long-acting injectable drugs were independent risk factors for medication noncompliance in patients with psychotic disorders. Our nomogram for predicting treatment adherence behaviour in psychiatric patients exhibited good sensitivity and specificity.
Impact of musculoskeletal joint complaints on quality of life in patients with inflammatory bowel disease: a cross-sectional study
Authors: Jamal Maha , Karreman Maren , de Bruijne Frederieke , Kuijper T. Martijn , Hazes J M , Lopes Barreto Deirisa , Weel Angelique E
Published: November 2024

Background

Musculoskeletal joint complaints (MSCs) are the most common extraintestinal manifestation of inflammatory bowel disease (IBD). We aimed to investigate the effect of MSC on the health-related quality of life (QoL) in patients with IBD.

Design

A survey-based cross-sectional study among adult Dutch IBD patients.

Setting

Primary care, secondary care and patient association.

Participants

In total, 635 IBD patients were included. The mean age was 46.3 (SD 14.2) years, and 35% were male.

Outcome

MSC was defined as suffering from any joint complaints. QoL was measured using the IBD questionnaire and a 36-item short form health survey questionnaire.

Methods

A univariate analysis was performed to estimate the impact of various factors, such as demographic characteristics, setting, type of IBD and fatigue, which was followed by a multiple regression analysis to adjust for the confounding factors.

Results

Of the 635 IBD patients, 332 suffered from Crohn’s disease (CD) and 303 from ulcerative colitis (UC). After adjusting for confounding factors, MSC was independently associated with reduced QoL among IBD patients (β=−10.6, 95% CI −15.2 to −6.1), both in CD (β=−8.3, 95% CI −14.6 to −2.1) and UC (β=−13.9, 95% CI −20.5 to −7.3). 11% of the IBD patients had a rheumatological diagnosis. QoL in these patients was significantly lower compared with IBD patients with non-rheumatological MSC.

Conclusions

IBD patients with MSC are associated with a lower QoL, explicitly in patients with a rheumatological diagnosis. Prospective research is necessary to evaluate the causality and suitable interventions to increase QoL in these multimorbid patients.
Trajectories of functional limitations, health-related quality of life and societal costs in individuals with long COVID: a population-based longitudinal cohort study
Authors: Wang Jiunn , Goodfellow Henry , Walker Sarah , Blandford Ann , Pfeffer Paul , Hurst John R , Sunkersing David , Bradbury Katherine , Robson Chris , Henley William , Gomes Manuel
Published: November 2024

Objectives

To examine trajectories of functional limitations, fatigue, health-related quality of life (HRQL) and societal costs of patients referred to long COVID clinics.

Design

A population-based longitudinal cohort study using real-time user data.

Setting

35 specialised long COVID clinics in the UK.

Participants

4087 adults diagnosed with long COVID in primary or secondary care deemed suitable for rehabilitation and registered in the Living With Covid Recovery (LWCR) programme between 4 August 2020 and 5 August 2022.

Main outcome measures

Generalised linear mixed models were fitted to estimate trajectories of functional limitations, using the Work and Social Adjustment Scale (WSAS); scores of ≥20 indicate moderately severe limitations. Other outcomes included fatigue using the Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F) reversed score (scores of ≥22 indicate impairment), HRQL using the EQ-5D-5L, and long COVID-related societal costs, encompassing healthcare costs and productivity losses.

Results

The mean WSAS score at 6 months after registration in the LWCR was 19.1 (95% CI 18.6, 19.6), with 46% of the participants (95% CI 40.3%, 52.4%) reporting a WSAS score above 20 (moderately severe or worse impairment). The mean change in the WSAS score over the 6-month period was −0.86 (95% CI −1.32, –0.41). The mean reversed FACIT-F score at 6 months was 29.1 (95% CI 22.7, 35.5) compared with 32.0 (95% CI 31.7, 32.3) at baseline. The mean EQ-5D-5L score remained relatively constant between baseline (0.63, 95% CI 0.62, 0.64) and 6 months (0.64, 95% CI 0.59, 0.69). The monthly societal cost per patient related to long COVID at 6 months was £931, mostly driven by the costs associated with working days lost.

Conclusions

Individuals referred to long COVID clinics in the UK reported small improvements in functional limitations, fatigue, HRQL and ability to work within 6 months of registering in the LWCR programme.
‘Blue-lighting’ seizure-related needs in care homes: a retrospective analysis of ambulance call-outs for seizures in North West England (2014–2021), their management and costs, with community comparisons
Authors: Noble Adam J , Lane Steven , Lloyd Peter , Morris Beth , Bell Steve , Shillito Tom , Dixon Pete , Marson Anthony Guy
Published: November 2024

Objectives

With a projected rise in care home residency and the disproportionate impact of epilepsy and seizures on older adults, understanding seizure-related needs in this population is crucial. Data silos and inconsistent recording of residence status make this challenging. We thus leveraged ambulance data to investigate seizure call-out incidence, characteristics, management and costs in care homes compared with the wider community.

Design

Retrospective analysis of dispatch data from a regional English ambulance service over four 9-month periods between 2014/2015 and 2021/2022. Suspected seizures in adults (≥16 years) were identified, with data on location, patient age, severity and management extracted. Incidence rates, trends over time and case characteristics were compared. Costs of ambulance response were estimated, and factors influencing emergency department (ED) conveyance were analysed using logistic regression.

Setting

North West Ambulance Service National Health Service Trust, serving an adult population of ~5.5 million.

Participants

Dispatch data for 98 752 suspected seizure cases.

Results

Care homes, accommodating ~0.8% of the regional population, accounted for 7.2% of seizure call-outs. Incidence was higher in care homes than the wider community (55.71 vs 5.97 per 1000 person/year in 2021/2022) and increased over time. Care home cases peaked around 8:00–9:00. Despite similar or lower severity, they had a higher ED conveyance rate (78.3% vs 70.6%). Conveyance likelihood was influenced by factors beyond severity: reduced in homes specialising in learning disabilities (adjusted OR=0.649) and increased in homes with nursing provision (adjusted OR=1.226). Care homes accounted for 7.26% of the £24 million cost.

Conclusions

This study highlights the growing seizure-related needs in care homes. Despite similar severity, most cases result in ED conveyance. Future research should examine the appropriateness and implications of these transfers, ensuring specialist services support the care home population effectively.
Multicentre randomised controlled trial comparing Bankart repair with remplissage and Latarjet procedure in shoulder instability with subcritical bone loss (STABLE): study protocol
Authors: Khan Moin , Bedi Asheesh , Degen Ryan , Warner Jon , Bhandari Mohit
Published: November 2024

Introduction

Recurrent shoulder dislocations often cause attrition of the labrum and progressive loss of the anterior bony contour of the glenoid. Treatment options for this pathology involve either soft tissue repair or bony augmentation procedure. The optimal management for patients with shoulder instability with subcritical bone loss remains unknown and current clinical practice is highly varied.

Methods and analysis

The Shoulder instability Trial comparing Arthroscopic stabilisation Benefits compared with Latarjet procedure Evaluation (STABLE) is an ongoing multicentre, randomised controlled trial of 114 patients diagnosed with recurrent anterior shoulder instability and subcritical glenoid bone loss (10%–20%, measured on 3D CT using circle of best fit technique). Patients are randomised either arthroscopic capsuloligamentous repair (Bankart repair+remplissage) or open or arthroscopic coracoid transfer (Latarjet procedure). The primary outcome of this trial will be the between-group difference in the change from baseline to 24 months postintervention in Western Ontario Shoulder Instability Index scores. Secondary outcomes include: (1) rates of recurrent shoulder dislocations and symptoms of instability up to 24 months’ postsurgery; (2) clinical outcomes measured by American Shoulder and Elbow Society score, Shoulder Activity Scale, EQ-5D and Patient Satisfaction Scale; (3) physical examination (range of motion, stability); (4) return to previous level of activity/sport; (5) rate of shoulder-related complications and serious adverse events.

Ethics and dissemination

This protocol has been reviewed and approved by the Hamilton Integrated Research Ethics Board (HiREB; project number 15998) prior to commencement of the trial. Results from the study will be submitted for publication in a peer-reviewed journal regardless of whether there are statistically significant findings.

Trial registration number

NCT05705479; this study was prospectively registered on clinicaltrials.gov.
Biomedical research grant resubmission: rates and factors related to success – a scoping review
Authors: Lasinsky Anne M , Wrightson James , Khan Hassan , Moher David , Kitchin Vanessa , Khan Karim , Ardern Clare L
Published: November 2024

Objectives

Most first-time biomedical research grant applications are not funded. In the challenging research funding climate, resubmitting a grant application is a necessary task for scientists. Identifying which factors influence their decision to resubmit and the success of resubmissions will inform funders and applicants. However, data on resubmissions are fragmented and under-reported. In this scoping review, we aimed to summarise (1) the outcomes of resubmitting biomedical research grant applications and (2) the demographic characteristics of scientists who resubmitted grant applications.

Design

Scoping review with reporting informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

Data sources

MEDLINE, CINAHL, EMBASE, Cochrane Central Registrar of Controlled Trials CENTRAL, PsycINFO, Web of Science and grey literature sources were searched through November 2022.

Eligibility criteria

We included peer-reviewed and grey literature records from the biomedical sciences that reported outcomes of the resubmission process (eg, resubmission success rate, rate of resubmission) and information about the scientists who resubmit grant applications (eg, sex, race, career stage).

Data extraction and synthesis

Data were extracted independently by two reviewers. The data were cross-referenced and any conflicts were resolved via consensus. Data were summarised descriptively and presented in tables and figures.

Results

Resubmissions represented a substantial proportion of applications (lowest prevalence rate: 4%; highest prevalence rate: 56%) in a given funding cycle and were reliably more successful than first-time applications (lowest success rate: 16%; highest success rate: 82%)—a phenomenon associated with several sociodemographic, institutional and project-related factors. There was conflicting evidence about the relationship of sociodemographic-related, institution-related and project-related factors to resubmission likelihood and success.

Conclusion

The resubmission process is a time-consuming and often frustrating experience for researchers. Our review identified opportunities to streamline and improve the process to enhance the biomedical research landscape.
Management of Post-transplant Infections in Collaborating Hospitals (MATCH) Programme: a prospective cohort of all transplant recipients at Copenhagen University Hospital—Rigshospitalet, Denmark
Authors: Esmann Frederik Viggo Lautrup , Zahid Sadaf , Moestrup Kasper Sommerlund , Normand Nick , Matthews Charlotte , Gustafsson Finn , Sengeløv Henrik , Perch Michael , Schultz Nicolai Aagaard , Sørensen Søren Schwartz , Hansen Jesper Melchior , Christensen Vibeke Brix , Murray Daniel D , Lundgren J , Crone Cornelia Geisler , Helleberg Marie
Published: November 2024

Purpose

The Management of Post-transplant Infections in Collaborating Hospitals (MATCH) programme, initiated in 2011 and still ongoing, was created to 1) optimise the implementation of existing preventive strategies against viral infections in solid organ transplant (SOT) recipients and allogenic haematopoietic stem-cell transplant (HSCT) recipients and 2) advance research in the field of transplantation by collecting data from a multitude of sources.

Participants

All SOT and HSCT recipients at Copenhagen University Hospital, Rigshospitalet, are followed in MATCH. By February 2021, a total of 1192 HSCT recipients and 2039 SOT recipients have been included. Participants are followed life long. An automated electronic data capture system retrieves prospective data from nationwide registries. Data from the years prior to transplantation are also collected.

Findings to date

Data entries before and after transplantation include the following: biochemistry: 13 995 222 and 26 127 817; microbiology, cultures: 242 023 and 410 558; other microbiological analyses: 265 007 and 566 402; and pathology: 170 884 and 200 394. There are genomic data on 2431 transplant recipients, whole blood biobank samples from 1003 transplant recipients and faeces biobank samples from 207 HSCT recipients. Clinical data collected in MATCH have contributed to 50 scientific papers published in peer-reviewed journals and have demonstrated success in reducing cytomegalovirus disease in SOT recipients. The programme has established international collaborations with the Swiss Transplant Cohort Study and the lung transplant cohort at Toronto General Hospital.

Future plans

Enrolment into MATCH is ongoing with no planned end date for enrolment or follow-up. MATCH will continue to provide high-quality data on transplant recipients and expand and strengthen international collaborations.
Effectiveness of HIV prevention interventions targeting long-distance truck drivers: protocol for a systematic review and meta-analysis of global evidence
Authors: Mutie Cyrus , Otieno Berrick , Kithuci Kawira , Gachohi John , Mbuthia Grace
Published: November 2024

Introduction

Globally, long-distance truck drivers’ (LDTDs) risk of exposure to HIV infections is higher compared with other populations in transit. Thus, several HIV prevention interventions have been implemented, though to a narrower extent compared with other most at-risk populations. Consequently, the effectiveness of such interventions is not well understood. Therefore, a review is warranted to inform policymakers on the most effective HIV prevention interventions targeted for LDTDs.

Methods and analysis

The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines were followed. Original peer-reviewed interventional studies involving LDTDs of either gender aged above 18 years, and reporting findings on HIV prevention interventions from any part of the world will be included. Non-empirical research studies like systematic reviews, literature reviews and scoping reviews will be excluded. A comprehensive search will be done from PubMed, Cumulated Index to Nursing and Allied Health Literature and other five databases to identify eligible studies. The Rayyan online platform will be used for the screening of titles and abstracts. For the meta-analysis, a random-effects meta-analysis using the ‘metafor’ package in R software will be done. Where specific studies may not report adequate data for meta-analysis, their findings will be presented qualitatively. The Cochrane Collaboration tool and Joanna Brigs Checklist will be used to assess the quality and risk of bias in the included studies.

Ethics and dissemination

A formal ethical approval is not required for this systematic review and meta-analysis. The findings will be presented at scientific conferences and published in open-access peer-reviewed journals to reach policymakers, stakeholders and the scientific community.

PROSPERO registration number

CRD42024505542.
Study protocol of the planetary health action survey PACE: a serial cross-sectional survey to assess the readiness to act against climate change
Authors: Lehrer Lena , Geiger Mattis , Sprengholz Philipp , Jenny Mirjam , Temme Hellen L , Shamsrizi Parichehr , Eitze Sarah , Betsch Cornelia
Published: November 2024

Introduction

Climate change is a paramount global health threat with multifaceted implications. Societal change is required to mitigate the negative effects of climate change, as well as help people adapt to the associated health risks. This requires situation-specific, large-scale data to help scientists and policymakers understand public perceptions and behaviours and identify the levers to increase public readiness to act against climate change and protect health. The Planetary Health Action Survey (PACE) assesses this readiness to act as a regular monitoring of representative samples in Germany. The ongoing monitoring seeks to develop and refine an integrated conceptual model of the trait-like readiness to act, comprising policy acceptance, political participation and individual behaviours as indicators of the trait. It also proposes as set of determinants to explain different levels of readiness to act. This study protocol provides newly developed valid measurement instruments and the methodological details of the monitoring.

Method and analysis

PACE assesses indicators of the readiness to act and a set of sociocognitive factors predicting the readiness to act in continuous cross-sectional data collections. The latter comprise climate change knowledge, trust in institutions, perceived health risks, self-efficacy, social norms and perceived effectiveness of policy measures. The online questionnaire is updated regularly. Data collection involves non-probabilistic quota samples from Germany (n≈1000 at each collection).

Ethics and dissemination

The project adheres to the ethical guidelines of the University of Erfurt and the German Research Foundation. Ethical clearance was granted by the University’s Institutional Review Board (No #20220525/No #2024-01). Participants are guaranteed confidentiality and anonymity, and informed consent is obtained before participation. Results will be published in peer-reviewed journals. Additionally, we aim to inform and empower the public and support stakeholders (media, policymakers, climate protection organisations) in preparing climate communication and assisting policymakers through the project website including an interactive tool, detailed reports and short summaries for practitioners.
Effects of Baduanjin exercise on cancer-related fatigue in patients with prostate cancer treated with androgen deprivation therapy in Shanghai, China: a study protocol for a randomised controlled trial
Authors: Wang Yihang , Qin Yuan , Xu Xiruo , Li Yali , Zhu Xuanying , Yang Guangpu , Xu Yifei , Yao Fei , Guo Guangxin
Published: November 2024

Introduction

Cancer-related fatigue (CRF) is one of the most common and painful symptoms in patients with prostate cancer (PCa). Moreover, PCa patients who receive the androgen deprivation therapy (ADT) are more likely to develop CRF. Baduanjin exercise has been shown to improve CRF in some cancers. However, such effects have not been verified in patients with PCa treated with the ADT. So, this study was designed as a randomised controlled trial (RCT) to explore the effects of Baduanjin exercise on CRF in PCa patients treated with the ADT.

Methods and analysis

This study will be a single-centre, assessor and statistician blinded, RCT consisting of a 12 week intervention and 12 week follow-up. Patients with PCa who meet the inclusion criteria will be recruited from Shanghai Hudong Hospital. Participants will be randomly assigned to Baduanjin exercise group (n=42) and the control group (n=42), performing 12 weeks of Baduanjin exercise or reeiving the standard care. The primary outcome will be the clinical effect of Baduanjin exercise on CRF in PCa patients, which will be measured using the Piper Fatigue Self-Assessment (PFS) scale, a multidimensional measure of CRF using three different dimensions: somatic, emotional and cognitive. The secondary outcome will be the clinical effect of the Baduanjin exercise on the patient’s level of fatigue, sleep, depression and life quality at the time, which will be assessed by the Brief Fatigue Inventory (BFI), the Pittsburgh Sleep Quality Index (PSQI), the Beck Depression Inventory (BDI) and the Functional Assessment of Cancer Therapy-Prostate (FACT-P).

Ethics and dissemination

This study has been approved by Shanghai Hudong Hospital Ethics Committee, Shanghai province (2022 SHHDKY08). The trial results will be submitted to conferences and peer-reviewed journals.

Trail registration number

ChiCTR2300074293
“Whenever I help her, I am also expecting her vagina in return”: a qualitative analysis to explore men’s and adolescent girls’ perceptions of the impact of the COVID-19 pandemic on the sexual behaviour and health of adolescent girls in rural western Kenya
Authors: Awiti Enid , Young Sophie , Zulaika Garazi , Otieno Fredrick Odhiambo , Nyothach Elizabeth , Phillips-Howard Penelope A , Mehta Supriya D , Mason Linda
Published: November 2024

Introduction

The COVID-19 pandemic caused school closures, which intensified the negative sexual and reproductive health (SRH) of adolescent girls in sub-Saharan Africa (SSA), including increases in transactional sexual partnerships, gender-based violence, risk of early pregnancy and sexually transmitted infections (STIs). We conducted a qualitative study to understand how adolescent girls experienced and reacted to the pandemic restrictions and perceived consequences on their schooling and sexual behaviours. In parallel, we sought community men’s perceptions and opinions on the same issues.

Methods

Set in rural western Kenya, the study used six focus group discussions with adolescent girls and five with community males aged 19–41 years, conducted from June 2022 to January 2023.

Results

Thematic analysis identified three key themes, parallel in girls and men: (1)impacts of COVID-19 on schooling: girls reported uncertainty around ever returning to education, consequently losing motivation to study, which was also observed by men; (2)drivers that increased sexual activity: transactional sex became a greater necessity due to acute poverty, while opportunity escalated through additional leisure time and (3)sexual behaviours and practices: girls increased the number of partners and frequency of sexual encounters, with power-imbalances reported. Men believed they were assisting girls through transactional sex but this was often conditional on receiving sex in return, viewing themselves as victims of girls’ seductive advances, and blaming girls for transmitting STIs.

Conclusion

School closure jeopardised girls’ SRH through acute poverty and increased opportunity for sexual exposure. Mitigation methods are needed now to prevent girls bearing the brunt of ensuing societal disruption and acute poverty in future catastrophes. Deeper understanding of men’s attitudes and behaviours towards adolescent girls are needed to improve the foundation for working with them to reduce power imbalance and compulsion in sexual interactions with adolescent girls.
Relationship between diabetes-related clinical characteristics and preserved ratio impaired spirometry (PRISm): findings from NHANES 2007–2012
Authors: Tang Xingyao , Huang Ke , Chu Xu , Peng Yaodie , Huang Tingting , Cui Yanan , Yang Ting , Wang Chen
Published: November 2024

Introduction

To analyse the relationship between diabetes, its severity (including blood glucose levels, disease duration, antidiabetic drug use and number of comorbidities) and preserved ratio impaired spirometry (PRISm) using data from the National Health and Nutrition Examination Survey (NHANES).

Methods

This cross-sectional study collected data from the NHANES database from 2007 to 2012. PRISm was defined as having a forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) ratio ≥0.7 and an FEV1 predicted value <80%. We examined the relationship between diabetes duration, fasting plasma glucose (FPG), glycated haemoglobin (HbA1c), log-transformed homeostasis model assessment for insulin resistance, C reactive protein and the number of comorbidities with PRISm in the entire population. We analysed the relationship between antidiabetic drug use and PRISm, specifically in the diabetes population. Logistic regression models were used, and results were reported as OR.

Results

A total of 5783 participants with normal spirometry or PRISm were included in the analysis. Diabetes was associated with 2.19 times higher odds of PRISm compared with non-diabetic participants. Longer disease duration increased PRISm odds by 2% per year. Each 1-unit increase in HbA1c and each 10 mg/dL increase in FPG were associated with 24% and 6% higher odds of PRISm, respectively. No relationship was found between insulin resistance and PRISm after adjusting for covariates. An increase of 1 mg/dL in CRP was associated with 18% higher odds of PRISm. A higher number of diabetes-related comorbidities was strongly associated with PRISm. No significant relationship was found between antidiabetic drug use and PRISm.

Conclusions

Severe diabetes status, such as higher blood glucose levels, longer disease duration and a greater number of comorbidities, is associated with an increased risk of PRISm. Effective blood glucose control, self-management and regular monitoring of lung function are crucial for diabetes management.
Design and validation of Iranian Child Health-Friendly Neighbourhood checklist: a mixed-methods study
Authors: Akhbari Parisa , Keshavarz Mohammadi Nastaran , Zayeri Farid , Ramezankhani Ali , Hakimian Pantea , Sahamkhadam Nasrin
Published: November 2024

Background

A child health-friendly neighbourhood is defined as a neighbourhood where the child’s health is provided, protected and promoted. Designing and validation of an assessment tool is required to identify the deficits and strengths of neighbourhoods within the context of each country. This study aimed to design and validate a child health-friendly neighbourhood assessment tool in Tehran.

Methods

A mixed-methods approach using semistructured interviews with 31 participants (15 mothers of children under 6 years old and 16 experts) conducted in Tehran between 2021 and 2022. Face validity, content validity and reliability of the checklist were calculated. Highly influenced by the Child Friendly City framework, designing and validation of the checklist was carried out through three phases: (a) identifying the child health-friendly neighbourhood domains and subdomains, (b) drafting the Iranian Child Health-Friendly Neighbourhood checklist and (c) validation of the designed checklist.

Results

Following three phases of study, the final version of the checklist consisted of six dimensions, namely green space and park, recreational centre, passage and street, healthcare centre, cultural centre and kindergarten. Each dimension encompassed five domains of facilities and services, accessibility, security, safety and aesthetics and view, with 42 indicators, 77 subindicators and 273 items.

Conclusions

The child health-friendly neighbourhood checklist has a more health focus on neighbourhood level and is more contextually specific, relevant and appropriate compared with UNICEF’s Child Friendly City framework. It also showed acceptable validity and reliability; therefore, the checklist could be a feasible tool to assess child health-friendly neighbourhoods.
Original salivary sex hormone data of naturally menstruating athletes and hormonal contraceptive users
Authors: Lafitte Alice , Dupuit Marine , Chassard Tom , Barlier Kilian , Badier Nolwenn , Duclos Martine , Toussaint Jean-François , Antero Juliana da Silva
Published: November 2024

Objectives

There is a lack of data on salivary sex hormones across the menstrual cycle (MC) or hormonal contraceptive (HC) cycle of elite athletes. We aimed to provide original data on salivary sex hormones (17β-estradiol, progesterone and free testosterone) in naturally menstruating female athletes with a regular cycle or irregular cycle and using combined HC. A secondary purpose was to compare these data with published data from the general population according to the menstrual status (MC or HC or irregularly menstruating).

Methods

367 saliva tests were performed on 44 elite athletes during 6 months of follow-up to certify for cycle regularity. Athletes were grouped into regular MC, n=13; irregular MC, n=5; and HC, n=26. We compared salivary data of regular MC across six cycle phases (menses, mid-follicular, late follicular, early luteal, mid-luteal and late luteal phases) with published data from women with a similar MC or HC status from the general population.

Results

We provided salivary original data according to six sub-phases among elite athletes with regular MC. HC athletes showed lower salivary sex hormonal levels, markedly after the first week of active HC compared with regular MC. Athletes with irregular cycles do not show a progesterone rise from the first half to the second half of the cycle (Δirregular=0.38 (1.90), a rise detectable within regular MC group ΔregularMC=2.86 (2.88)).

Conclusions

We provided original data for salivary sex hormone levels in elite female athletes. These references may be valuable for research investigating MC or combined HC data, particularly in longitudinal follow-ups requiring repeated measurements.
Inverse linear association between blood haemoglobin and oxygen saturation accuracy measured by pulse oximetry: a cross-sectional analysis in individuals with COVID-19 infection
Authors: Crooks Colin J , West Joe , Morling Jo R , Simmonds Mark , Juurlink Irene , Briggs Steve , Cruickshank Simon , Hammond-Pears Susan , Shaw Dominick , Card Tim R , Fogarty Andrew W
Published: November 2024

Background

Pulse oximetry measures oxygen saturation non-invasively by using differential absorption of infrared signals which are dependent on the oxyhaemoglobin:deoxyhaemoglobin ratio. We tested the hypothesis that pulse oximetry error in measurements of blood oxygen saturations may be associated with blood haemoglobin levels.

Methods

The study design was an observational study of all adult patients admitted to a large teaching hospital with suspected or confirmed COVID-19 infection from February 2020 to December 2021 who had arterial blood gases (ABG) drawn. The pulse oximetry reading was compared with the arterial saturation on the ABG and the measurement error was determined according to the ABG haemoglobin. A secondary analysis was performed among a subset of patients with venous haemoglobins drawn within 24 hours, comparing measurement error between ABG arterial saturation and pulse oximetry readings between those with normal (150 g/L) and low (70 g/L) haemoglobins.

Results

The analysis used 5922 paired oxygen saturations from 3994 patients with contemporaneous haemoglobin measurements by ABG. A 1 g/L decrease in blood haemoglobin was associated with an 0.021% (95% CI: +0.008% to +0.033%) increase in the measurement error (in the direction of a falsely elevated reading.). In the 1086 patients who had had a venous haemoglobin there was a 0.055% (95% CI: +0.020% to +0.090%) increase in the measurement error of oxygen saturation per 1 g/L decrease in blood haemoglobin. The measurement error was thus greater in those with anaemia than in those with normal haemoglobin.

Conclusion

As blood haemoglobin decreases, the oxygen saturation measurement derived from a pulse oximeter reads erroneously higher than the true value measured by ABG. While this study was confined to patients with COVID-19, physicians should be aware of this potential discrepancy among all patients with haemorrhage or known anaemia
‘Renoviction’ and health: an emerging research agenda
Authors: Ross Heather , McCartney Gerry
Published: November 2024

Mitigating climate change requires us to rapidly improve the energy efficiency of our existing housing, a process known as ‘retrofit’. However, this creates the risk of ‘renoviction’, whereby tenants are moved or evicted to allow these renovations to take place. Understanding the potential for renoviction to undermine the potential population health benefits of retrofit is an important new area for research.
Wish to die trying to live: unwise or incapacitous? The case of University Hospitals Birmingham NHS Foundation Trust versus ‘ST’
Authors: Wellesley Johnna , Wilkinson Dominic , Moore Bryanna
Published: November 2024

The recent legal dispute about medical treatment for a 19-year-old patient, Sudiksha Thirumalesh, (known initially by the Court of Protection as ‘ST’) in A NHS Trust versus ST & Ors (2023) raised several challenging ethical issues. While Sudiksha’s case bears similarities to other high-profile cases in England and Wales, there are key differences. Crucially, Sudiksha herself was part of the disagreement. She was alert, communicative and sought to advocate for herself. Furthermore, this case was framed in the courts as pivoting not on considerations of best interests but on a determination of decisional capacity. Sudiksha was deemed to lack capacity because she did not believe her doctors’ view of her prognosis.

While the legal questions in the case were central to a recent Court of Appeal decision (which overturned the original finding), in this commentary, we focus on the ethical questions therein. We start by describing Sudiksha’s court case and the initial judgment. We then offer an ethical analysis of the relationship between false beliefs, values and the ‘capacity’ to make decisions, arguing for a need for particular care when judging patients to lack capacity based purely on ‘false and fixed beliefs’. After briefly noting the legal basis for the appeal finding, we offer ethical implications for future cases. Although it appears that Sudiksha had decision-making capacity, this did not settle the ethical question of whether health professionals were obliged to continue treatment that they believed to have no prospect of success.
Association of prior tuberculosis with cardiovascular status in perinatally HIV-1-infected adolescents
Authors: Magodoro Itai M , Guerrero-Chalela Carlos Eduardo , Carkeek Emma , Asafu-Agyei Nana Akua , Jele Nomawethu , Frigati Lisa J , Myer Landon , Jao Jennifer , Ntsekhe Mpiko , Wilkinson Katalin A , Wilkinson Robert J , Zar Heather , Ntusi Ntobeko
Published: November 2024

Background

Whether, and how, co-occurring HIV-1 infection (HIV) and tuberculosis (TB) impact cardiovascular status, especially in adolescents with perinatally acquired HIV (APHIV), have not been examined. We hypothesised that APHIV with previous TB disease have worse cardiac efficiency than APHIV without TB, which is mediated by increased inflammation and disordered cardiometabolism.

Methods

APHIV in Cape Town, South Africa, completed 3T cardiovascular magnetic resonance examination and high sensitivity C reactive protein (hsCRP), fasting plasma glucose (FPG), low-density lipoprotein (LDL) and triglyceride measurement. Ventriculoarterial coupling (VAC) was estimated as the ratio of arterial elastance (Ea) to ventricular end-systolic elastance (Ees). Regression models were applied to estimate cross-sectional associations between Ea/Ees ratio and TB status, with decomposition of these associations into direct and mediated effects of hsCRP, FPG and dyslipidaemia, if any, attempted.

Results

We enrolled 43 APHIV with prior TB and 23 without TB of mean (SD) age 15.0 (1.5) and 15.4 (1.7) years, respectively. Prior TB was associated with lower Ea/Ees ratio (0.59 (0.56 to 0.64)) than no TB (0.66 (0.62 to 0.70)), which corresponded to an adjusted mean difference −0.06 (−0.12 to 0.01) (p=0.048). However, previous TB was not associated with increased hsCRP, FPG, LDL or triglycerides nor were hsCRP, FPG, LDL and triglycerides associated with Ea/Ees ruling out their mediated effects in the association between TB and cardiac efficiency.

Conclusions

Previous TB in APHIV is associated with comparatively reduced cardiac efficiency, related to altered VAC. The clinical significance of these findings requires further study, including a wider range of biomarkers of specific immune pathways.
Systematic review and meta-analysis of the association between naturally induced IgG, IgM and neutralising antibodies to HPV16 and newly detected cervical HPV16 infection outcomes
Authors: Trevisan Andrea , de Araujo-Souza Patricia S , Pincivy Alix , Niyibizi Joseph , Franco Eduardo L , Trottier Helen
Published: November 2024

Background

It is unclear whether recurrent cervical human papillomavirus type 16 (HPV16) infections can be prevented by naturally induced HPV16 antibodies in unvaccinated healthy women.

Methods

We systematically searched the literature for studies that prospectively evaluated the association between HPV16 naturally induced IgG, IgM, and neutralising antibodies and newly detected cervical HPV16 infection in unvaccinated women. Data were quantitatively summarised by random effect meta-analysis.

Results

Naturally induced HPV16 IgG and neutralising antibodies were negatively associated with newly detected HPV16 infection (relative risk (RR) (95% confidence interval (CI))=0.71 (0.63 to 0.80) and 0.54 (0.36 to 0.73), respectively). HPV16 antibodies tend to offer protection against subsequent HPV16 DNA detection in young women (RR (95% CI)=0.65 (0.55 to 0.74)), but not in women aged over 25 years (RR (95% CI)=0.88 (0.73 to 1.04)). HPV16 IgG antibodies were also negatively associated with persistent HPV16 infection (adjusted RR=0.67 (0.56 to 0.78)). There was high heterogeneity between studies (I2statistic=63.9%; p=0.007), and most had low risk of bias. We did not find studies evaluating IgM antibodies.

Conclusion

Seroreactivity to HPV16 infection seems to provide moderate protection against newly detected cervical HPV16 infection outcomes in unvaccinated women. However, protection seems to be affected by age. These findings should be considered when evaluating public health interventions against HPV.

PROSPERO registration number

CRD42022339579.
Total and unprotonated (freebase) nicotine content in new types of oral ‘tobacco-free’ nicotine products
Authors: Tran Hang , Tyx Robert E , Valentin Liza , Mahoney Margaret , Stanfill Stephen , Watson Clifford H
Published: November 2024

Significance

Nicotine-containing products, labelled as being ‘tobacco-free’ nicotine (TFN), are marketed to consumers as alternatives to conventional tobacco products. Little is known about these emerging products and their contents.

Methods

Moisture, total nicotine and pH content were analysed in 70 commercially available TFN products, covering five different types (lozenges, chewing gum, loose leaf, toothpicks and pouches). The freebase nicotine was calculated using the measured pH values.

Results

Total nicotine levels ranged from 0.822 to 31.5 mg/g. Nicotine levels were highest in nicotine pouches (1.41–8.11 mg/product) and lowest in toothpicks (1.19–1.57 mg/product). Nicotine levels in TFN loose leaf (1.26–9.16 mg/g) were comparable to conventional moist snuff. The pH ranged from pH 4.68 to 9.49 and per cent freebase nicotine ranged from 0.0453% to 96.7%. The freebase nicotine content was highest in nicotine pouches (2.15–16.8 mg/g) and lowest in lozenges (0.0004–0.349 mg/g). The majority of TFN products (91.4%) analysed were advertised to contain flavour components.

Conclusion

Overall, products advertised as higher strength were found to have higher nicotine content than products advertised as lower strength. The measured total nicotine content was either equal to or less than the level stated on the label, except for one product. Although TFN products may not contain tobacco lamina and may lack many harmful chemicals and carcinogens found in conventional smokeless products, freebase nicotine levels in the pouch products are elevated and could contribute to higher levels of addiction and other negative health effects.
Entangled quantum fridge using a two spin-12 Heisenberg system with Dzyaloshinskii–Moriya and Kaplan–Shekhtman–Entin-Wohlman–Aharony interactions as a working medium
Authors: Benzahra M. , Ait Chlih A. , Mansour M.
Published: November 2024

The connection between quantum entanglement and quantum refrigerators is an active area in quantum thermodynamics. Ongoing investigations are exploring how entanglement in the working medium of a quantum refrigerator can impact its performance. The paper focuses on a two-qubit Heisenberg XXZ spin-[Formula: see text] system featuring Kaplan–Shekhtman–Entin-Wohlman–Aharony (KSEA) and Dzyaloshinsky–Moriya (DM) spin–orbit exchange interactions as the operational physical matter medium for a quantum refrigerator. We provide explicit formulations for relevant thermodynamic quantities of the quantum refrigerator, dependent on the magnetic field (B) and the strengths parameters of spin–orbit interactions. The study explores the relationship between entanglement and thermodynamic properties, using concurrence as a quantitative metric of thermal entanglement. The results emphasize the significant impact of fine-tuning the amplitudes of both DM and [Formula: see text] strengths on improving the quantum refrigerator’s performance. Finally, the findings suggest that entanglement between the qubits is superfluous for enhancing the quantum refrigerator’s efficiency.