bluuebunny/crossref_metadata_2025 huggingface dataset:
Pathways to leadership: what accounts for women’s (in)equitable career paths in the health sectors in India and Kenya? A scoping review
Authors: Saville Naomi M , Uppal Radhika , Odunga Sally Atieno , Kedia Sapna , Odero Henry Owoko , Tanaka Sonja , Kiwuwa-Muyingo Sylvia , Eleh Lawrence , Venkatesh Sucharitha , Zeinali Zahra , Koay Aaron , Buse Kent , Verma Ravi , Hawkes Sarah
Published: July 2024

Objectives

We aimed to capture evidence on enablers and barriers to improving equal opportunity and effective organisational interventions that can advance women’s leadership in India and Kenya’s health sectors.

Methods

We systematically searched JSTOR, PubMed, SCOPUS and Web of Science databases, reference lists of selected articles and Google Scholar using string searches. We included studies that were published in English from 2000 to 2022 in peer-reviewed journals or grey literature, focused on paid, formal health professionals in India or Kenya, described factors relating to women’s representation/leadership.

Results

We identified 26 studies, 15 from India and 11 from Kenya. From each country, seven studies focused on nursing. Participants included women and men health sector workers. Seven studies used mixed methods, 11 were qualitative, 5 were quantitative and 3 were commentaries. Factors influencing women’s career progression at individual/interpersonal levels included family support, personal attributes (knowledge/skills) and material resources. Factors at the organisational level included capacity strengthening, networking, organisational policies, gender quotas, work culture and relationships, flexibility, and work burden. Nursing studies identified verbal/sexual harassment and professional hierarchies as barriers to career progression. Structural barriers included a lack of infrastructure (training institutes and acceptable working environments). Normative themes included occupational segregation by gender (particularly in nursing), unpaid care work burden for women and gender norms.

Studies of interventions to improve women’s career progression and sex-disaggregated workforce data in India or Kenya were limited, especially on leadership within career pathways. The evidence focuses on enablers and barriers at work, rather than on organisations/systems to support women’s leadership or address gender norms.

Conclusions

Women in India and Kenya’s health sectors face multiple impediments in their careers, which impact their advancement to leadership. This calls for gender-transformative interventions to tackle discrimination/harassment, provide targeted training/mentorship, better parental leave/benefits, flexible/remote working, family/coworker support and equal-opportunity policies/legislation.
The performance of digital technologies for measuring tuberculosis medication adherence: a systematic review
Authors: Zary Miranda , Mohamed Mona Salaheldin , Kafie Cedric , Chilala Chimweta Ian , Bahukudumbi Shruti , Foster Nicola , Gore Genevieve , Fielding Katherine L , Subbaraman Ramnath , Schwartzman Kevin
Published: July 2024

Introduction

Digital adherence technologies (DATs), such as phone-based technologies and digital pillboxes, can provide more person-centric approaches to support tuberculosis (TB) treatment. However, there are varying estimates of their performance for measuring medication adherence.

Methods

We conducted a systematic review (PROSPERO—CRD42022313526), which identified relevant published literature and preprints from January 2000 to April 2023 in five databases. Studies reporting quantitative data on the performance of DATs for measuring TB medication adherence against a reference standard, with at least 20 participants, were included. Study characteristics and performance outcomes (eg, sensitivity, specificity and predictive values) were extracted. Sensitivity was the proportion correctly classified as adherent by the DAT, among persons deemed adherent by a reference standard. Specificity was the proportion correctly classified as non-adherent by the DAT, among those deemed non-adherent by a reference standard.

Results

Of 5692 studies identified by our systematic search, 13 met inclusion criteria. These studies investigated medication sleeves with phone calls (branded as ‘99DOTS’; N=4), digital pillboxes N=5), ingestible sensors (N=2), artificial intelligence-based video-observed therapy (N=1) and multifunctional mobile applications (N=1). All but one involved persons with TB disease. For medication sleeves with phone calls, compared with urine testing, reported sensitivity and specificity were 70%–94% and 0%–61%, respectively. For digital pillboxes, compared with pill counts, reported sensitivity and specificity were 25%–99% and 69%–100%, respectively. For ingestible sensors, the sensitivity of dose detection was ≥95% compared with direct observation. Participant selection was the most frequent potential source of bias.

Conclusion

The limited number of studies available suggests suboptimal and variable performance of DATs for dose monitoring, with significant evidence gaps, notably in real-world programmatic settings. Future research should aim to improve understanding of the relationships of specific technologies, settings and user engagement with DAT performance and should measure and report performance in a more standardised manner.
Digital textbooks for undergraduate nursing education: a scoping review protocol
Authors: Jang Aeri , Park Hyunyoung
Published: July 2024

Introduction

Digital textbooks (DTs), in which students read dozens of paragraph clips and systematise their level of knowledge through new questions, can be an alternative for digital natives to consider. Developing DTs is required when teaching digital natives at undergraduate nursing schools. A scoping review is required to understand the current status of DTs in nursing education.

Methods and analysis

The preliminary search has been conducted to check whether the results produced by PubMed (NCBI) were published in English within 10 years and related to DTs. This study includes research targeting undergraduate nursing students. Literature will be further searched using Embase (Elsevier), Cochrane Library and Cumulative Index to Nursing and Allied Health (CINAHL) databases. This scoping review will also consider quantitative, qualitative, and mixed research methods, texts and opinion documents; review studies; and pilot tests. The chosen studies will first be extracted based on the scoping review data extraction section of Joanna Briggs Institute to identify their general characteristics. DTs will be analysed based on the e-textbook framework: information goods, technology and stakeholders.

Ethics and dissemination

The Institutional Review Board of Nambu University, South Korea, approved this study for review exemption (approval number: 1041478-2022-HR-009). The results of this study will be disseminated through research results to nursing education institutions and hospitals.

Open Science Framework

https://doi.org/10.17605/OSF.IO/QS6WH.
Robotic pancreaticoduodenectomy in patients with overweight or obesity: a meta-analysis protocol
Authors: Yang Wenxiao , Zeng Hai , Jin Yueling
Published: July 2024

Introduction

The prevalence of overweight or obesity among patients undergoing pancreaticoduodenectomy is on the rise. The utilisation of robotic assistance has the potential to enhance the feasibility of performing minimally invasive pancreaticoduodenectomy in this particular group of patients who are at a higher risk. The objective of this meta-analysis is to assess the safety and effectiveness of robotic pancreaticoduodenectomy in individuals with overweight or obesity.

Methods and analysis

This investigation will systematically search for randomised controlled trials (RCTs) and non-randomised comparative studies that compare robotic pancreaticoduodenectomy with open or laparoscopic pancreaticoduodenectomy in patients with overweight or obesity, using PubMed, Embase and the Cochrane Library databases. The methodological quality of studies will be evaluated using the Cochrane risk of bias tool for RCTs and the Newcastle-Ottawa Scale for observational studies. RevMan software (V.5.4.1) will be used for statistical analysis. The OR and weighted mean differences will be calculated separately for dichotomous and continuous data. The selection of a fixed-effects or random-effects model will depend on the level of heterogeneity observed among the included studies.

Ethics and dissemination

This study will be conducted based on data in the published literature from publicly available databases. Therefore, ethics approval is not applicable. The results will be disseminated in a peer-reviewed journal.

PROSPERO registration number

CRD42023462321.
Assessing environmental injustice in Kansas City by linking paediatric asthma to local sources of pollution: a cross-sectional study
Authors: Friedman Elizabeth , Lee Brian R , Rahn David , Lugo Martinez Beto , Mena Atenas
Published: July 2024

Objective

A grassroots environmental-justice organisation in Kansas City has been examining the disproportionate exposure to air pollution experienced by residents living fenceline to the largest classification railyard in the USA. Prior analyses showed limited increased risk for asthma exacerbation for patients with asthma living closer to toxic release inventory (TRI) facilities and railyards. In this study, we assessed geographical asthma and environmental disparities, to further explore community-level disparities.

Design

This is a cross-sectional study of population-level asthma rates, which included rates for all asthma encounters and acute asthma encounters (urgent care, emergency department, inpatient admission). Distances from census-tract centroids to nearest TRI facilities, railyards and highways were calculated. The association between asthma rates and distances was examined using Kendall’s τ correlation and multivariable Poisson regression models.

Setting

We used electronic medical record data from the regional paediatric hospital, census and Environmental Protection Agency (EPA) air monitoring data.

Participants

Patients with 2+ asthma encounters during the EPA study timeframe were identified.

Results

Residential distance from railyards exhibited a significant negative correlation with overall (−0.36 (CI −0.41 to –0.32)) and acute (−0.27 (CI −0.32 to –0.22)) asthma rates. Asthma rates were elevated among tracts north of the closest railyard (incident rate ratio: 1.38; CI 1.35 to 1.41) when compared with southern directionality. An increased distance from the nearest railyard of 3 km was associated with a decrease in overall asthma rates of 26%.

Conclusion

Significant negative associations between proximity to all pollution source types and asthma rates were observed. This community-level research has served as a tool for community engagement and will be used to support proposed local policy. Environmental justice work addresses local concerns involving small, limited datasets, if the data exist at all. The academic epidemiological platform may reconsider acceptable approaches to small population research in order to better serve communities with the most need.
Study protocol for a prospective, multicentre study of hypercortisolism in patients with difficult-to-control type 2 diabetes (CATALYST): prevalence and treatment with mifepristone
Authors: DeFronzo Ralph A , Auchus Richard J , Bancos Irina , Blonde Lawrence , Busch Robert S , Buse John B , Findling James W , Fonseca Vivian A , Frias Juan P , Hamidi Oksana , Handelsman Yehuda , Pratley Richard E , Rosenstock Julio , Tudor Iulia Cristina , Moraitis Andreas G , Einhorn Daniel
Published: July 2024

Introduction

Even with recent treatment advances, type 2 diabetes (T2D) remains poorly controlled for many patients, despite the best efforts to adhere to therapies and lifestyle modifications. Although estimates vary, studies indicate that in >10% of individuals with difficult-to-control T2D, hypercortisolism may be an underlying contributing cause. To better understand the prevalence of hypercortisolism and the impact of its treatment on T2D and associated comorbidities, we describe the two-part Hyper

c

ortisolism in P

at

ients with Difficult to Control Type 2 Di

a

betes Despite Receiving Standard-of-Care Therapies: Preva

l

ence and Treatment with Korl

y

m
®
(Mifepri

st

one) (CATALYST) trial.

Methods and analysis

In part 1, approximately 1000 participants with difficult-to-control T2D (haemoglobin A1c (HbA1c) 7.5%–11.5% despite multiple therapies) are screened with a 1 mg dexamethasone suppression test (DST). Those with post-DST cortisol >1.8 µg/dL and dexamethasone level ≥140 ng/dL are identified to have hypercortisolism (part 1 primary endpoint), have morning adrenocorticotropic hormone (ACTH) and dehydroepiandrosterone sulfate (DHEAS) measured and undergo a non-contrast adrenal CT scan. Those requiring evaluation for elevated ACTH are referred for care outside the study; those with ACTH and DHEAS in the range may advance to part 2, a randomised, double-blind, placebo-controlled trial to evaluate the impact of treating hypercortisolism with the competitive glucocorticoid receptor antagonist mifepristone (Korlym
®
). Participants are randomised 2:1 to mifepristone or placebo for 24 weeks, stratified by the presence/absence of an abnormal adrenal CT scan. Mifepristone is dosed at 300 mg once daily for 4 weeks, then 600 mg daily based on tolerability and clinical improvement, with an option to increase to 900 mg. The primary endpoint of part 2 assesses changes in HbA1c in participants with hypercortisolism with or without abnormal adrenal CT scan. Secondary endpoints include changes in antidiabetes medications, cortisol-related comorbidities and quality of life.

Ethics and dissemination

The study has been approved by Cleveland Clinic IRB (Cleveland, Ohio, USA) and Advarra IRB (Columbia, Maryland, USA). Findings will be presented at scientific meetings and published in peer-reviewed journals.

Trial registration number

NCT05772169
.
Association of sleep duration with Visceral Adiposity Index: a cross-sectional study based on the NHANES 2007–2018
Authors: Liu Juan , Gao Yajie , Ye Nan , He Xingkang , Zhang Jing
Published: July 2024

Objective

We aimed to assess the associations between sleep duration and Visceral Adiposity Index (VAI).

Design

Cross-sectional study.

Setting

The National Health and Nutrition Examination Survey (2007–2018).

Participants

A total 11 252 eligible participants who have complete information for sleep duration and VAI.

Outcome measure

The VAI index, which is sex-specific and takes into consideration factors such as waist circumference, body mass index, high-density lipoprotein cholesterol and triglycerides, was calculated in accordance with prior research. Multiple linear regressions and subgroup analyses were employed to evaluate the connection between the duration of sleep and the VAI.

Results

The mean sleep duration and VAI of included participants were 7.05 hours/day and 2.03, respectively. After adjusting for the sociodemographic, lifestyle and other covariates, short sleep was significantly linked to increased VAI (β=0.15, 95% CI 0.01 to 0.28) in relation to middle sleep duration, whereas no significant association was found between long sleep duration and VAI. An L-shaped relationship was observed between sleep duration and VAI. When sleep duration was less than 7.5 hours/day, a negative association between sleep duration and VAI was obvious. However, when sleep duration was >7.5 hours/day, VAI was increased with a longer sleep duration, although it was not significant.

Conclusions

An L-shaped relationship was observed between sleep duration and VAI, with insufficient sleep, being independently linked to a higher VAI. This implies that sleep deprivation might be associated with visceral adipose distribution and disfunction.
Comparing COVID-19 vaccination coverage, adverse reactions and impact of social determinants of health on vaccine hesitancy in ADRD/MCI and non-ADRD/MCI population: protocol for a retrospective cross-sectional study
Authors: Yang Yijiong , Park Hyejin , Li Chengdong , Song Dan , Wang Jing
Published: July 2024

Introduction

COVID-19 vaccination is crucial for vulnerable people with underlying chronic conditions such as Alzheimer’s disease and related dementias (ADRD) and mild cognitive impairment (MCI). These individuals face unique challenges, including higher risk of COVID-19, difficulties in adopting preventive behaviours and vaccine hesitancy due to concerns about adverse reactions. Therefore, efforts to promote vaccination, including boosters tailored to the currently circulating virus, are essential for people with ADRD/MCI.

Objective

The primary purpose of this study protocol is to conduct a comprehensive analysis of COVID-19 vaccination coverage and adverse reactions among individuals with ADRD/MCI in comparison to those without ADRD/MCI. Additionally, the proposed study aims to investigate the impact of social determinants of health on COVID-19 vaccination and vaccine hesitancy in individuals with ADRD/MCI.

Methods and analysis

A retrospective cross-sectional study will be conducted utilising data from theAll of Us (AoU) Researcher Workbench. Relevant data fields are extracted from sources including demographic information, COVID-19 Vaccine Survey, Basic Survey, Health Access & Utilization, Social Determinants of Health, and Electronic Health Record (EHR) data. Data on vaccination, adverse reactions and vaccine hesitancy will be collected through COVID-19 vaccine survey questionnaires. Propensity score matching and binary logistic regression will be applied to assess the vaccination rates and vaccine hesitancy, while controlling for demographic characteristics and social determinants of health factors.

Ethics and dissemination

This study protocol received approval from the Institutional Review Board at Florida State University (STUDY00004571). Results will be disseminated through publication in peer-reviewed journals and presented at scientific conferences.
Short-term and long-term stroke risk following SARS-CoV-2 infection in relation to disease severity: a Danish national cohort study
Authors: Schade Skov Camilla , Pottegård Anton , Harbo Andersen Jacob , Andersen Grethe , Lassen Annmarie Touborg
Published: July 2024

Objectives

Studies have reported high incidences of stroke in patients hospitalised with SARS-CoV-2, but the impact of disease severity is unexplored. We aimed to estimate the risk of incident ischaemic stroke in SARS-CoV-2 test-positive individuals compared with test-negative individuals stratified by disease severity during acute infection and post infection.

Design

A register-based cohort study.

Setting

A Danish nationwide study.

Participants

All Danish adults who had PCR tests for SARS-CoV-2 performed between 1 March 2020 and 30 November 2021. Test-positive individuals were included at their first positive test. For individuals tested prior to 30 November 2021, we randomly sampled an index date from the distribution of test dates among SARS-CoV-2 test-positive individuals. Test-positive individuals were followed during the acute phase of infection (days 0–14) and post infection (180 days after the acute phase). Test-negative individuals were followed in equivalent time periods.

Primary and secondary outcome measures

Incident ischaemic stroke risk in SARS-CoV-2 test-positive individuals compared with test-negative individuals during acute infection and post infection. We calculated subdistribution HRs (SHR) with death as a competing risk using propensity score weighting as confounder control. The risk was stratified according to disease severity: community managed, hospitalised, or admission to the intensive care unit.

Results

Among 3 910 219 SARS-CoV-2 PRC-tested individuals, 356 421 test-positive and 3 067 456 test-negative individuals were included. A positive SARS-CoV-2 test was associated with an SHR of 3.32 (95% CI 2.60 to 4.25) overall for stroke compared with test negative in the acute phase. In the postinfection period, the risk of stroke remained increased in individuals hospitalised during the acute phase (SHR 1.85, 95% CI 1.45 to 2.37). Individuals with community-managed SARS-CoV-2 had no increased long-term risk of stroke (SHR 1.01, 95% CI 0.88 to 1.16).

Conclusion

SARS-CoV-2 infection is associated with increased stroke risk. Disease severity seems to be an important factor. Individuals with community-managed SARS-CoV-2 had no increased stroke risk.
‘The health care system is more like a business’—medical overuse from the patients’ perspective in Germany: a qualitative study
Authors: Sebastião Maria , Pesch Josefine , Kühlein Thomas , Hueber Susann
Published: July 2024

Objectives

Medical overuse exposes patients to unnecessary risks of harm. It is an open question whether and how patients perceive the concept of medical overuse, its causes and negative consequences.

Design

A qualitative study design, using elements of the Grounded Theory Approach by Strauss and Corbin.

Setting

Between May 2017 and January 2020, we recruited participants and conducted face-to-face interviews in the participants’ homes. Data collection took place in Bavaria, Germany.

Participants

We recruited 16 participants (female=8, male=8) with various characteristics for the study. We used different strategies such as flyers in supermarkets, pharmacies, participants spreading information about the study or local multipliers (snowball sampling).

Results

The participants mostly defined medical overuse as too much being done but understood the concept superficially. During the interviews, most participants could describe examples of medical overuse. They named a variety of direct and indirect drivers with economic factors suspected to be the main driver. As a consequence of medical overuse, participants named the physical and emotional harm (eg, side effects of medication). They found it difficult to formulate concrete solutions. In general, they saw themselves more in a passive role than being responsible for bringing about change and solutions themselves. Medical overuse is a ‘problem of the others’. The participants emphasised that health education is important in reducing medical overuse.

Conclusions

Medical overuse was little discussed among participants, although many participants reported experiences of too much medicine. Health education and strengthening the patients’ self-responsibility can play a vital role in reducing medical overuse.
Serplulimab combined with gemcitabine, nab-paclitaxel and stereotactic body radiotherapy as the first-line treatment for patients with metastatic pancreatic adenocarcinoma in China: a multicentre, single-arm, phase II trial (ICSBR) protocol
Authors: Zhang Chenyan , Yang Heqi , Chang Chen , Li Ruizhen , Xiong Junjie , Kang Deying , He Du , Liu Xi-Jiao , Cheng Ke , Cao Dan
Published: July 2024

Introduction

Patients with pancreatic ductal adenocarcinoma (PDAC) remain a poor prognosis despite the development of chemotherapy. Although programmed cell death 1 (PD-1) blockade has shown great efficacy in various solid tumours, its application in treating PDAC is limited. Recent studies have indicated that chemotherapy or stereotactic body radiotherapy (SBRT) may improve the antitumour effect of PD-1 blockade in patients with PDAC. The objective of this study is to evaluate the efficacy and safety of combined therapy comprising PD-1 blockade, gemcitabine plus nab-paclitaxel chemotherapy and SBRT for patients with metastatic PDAC.

Methods and analysis

This is a multicentre, single-arm, prospective phase II clinical trial. Forty-three patients diagnosed with metastatic PDAC will be enrolled. The eligible patients will be intravenously administered 1000 mg/m2gemcitabine and 125 mg/m2nab-paclitaxel on days 1 and 8 of the 21-day cycle. Serplulimab (200 mg) will be administered intravenously on day 1 of the 21-day cycle. Furthermore, during the second cycle, the patients will undergo SBRT with doses of 33 Gy in five fractions for primary lesions or doses of 24 Gy in three fractions for metastases. The primary endpoint is the 6-month progression-free survival (PFS) rate. The secondary endpoints overall survival, PFS, overall response rate, disease control rate, time to progression, duration of response, duration of disease control and safety. Moreover, this trial seeks to investigate biomarkers such as circulating tumour DNA and circulating hybrid cells in patients diagnosed with metastatic PDAC.

Ethics and dissemination

The study was approved by the Ethics Committee on Biomedical Research, West China Hospital of Sichuan University. The study results will be presented at international conferences and published in a peer-reviewed journal.

Trial registration number

ChiCTR2300073237.
Protect peripheral intravenous catheters: a study protocol for a randomised controlled trial of a novel antimicrobial dressing for peripheral intravenous catheters (ProP trial)
Authors: Rickard Claire M , Drugeon Bertrand , Ullman Amanda , Marsh Nicole M , Corley Amanda , Ball Daner , O'Brien Catherine , Kleidon Tricia M , Guenezan Jérémy , Couvreur Raphael , McCarthy Kate L , Seguin Sabrina , Batiot Guillaume , Byrnes Joshua , Schults Jessica , Zahir Syeda Farah , Mimoz Olivier
Published: July 2024

Introduction

Peripheral intravenous catheters (PIVCs) are the most commonly used vascular access device in hospitalised patients. Yet PIVCs may be complicated by local or systemic infections leading to increased healthcare costs. Chlorhexidine gluconate (CHG)-impregnated dressings may help reduce PIVC-related infectious complications but have not yet been evaluated. We hypothesise an impregnated CHG transparent dressing, in comparison to standard polyurethane dressing, will be safe, effective and cost-effective in protecting against PIVC-related infectious complications and phlebitis.

Methods and analysis

The ProP trial is a multicentre, superiority, randomised clinical and cost-effectiveness trial with internal pilot, conducted across three centres in Australia and France. Patients (adults and children aged ≥6 years) requiring one PIVC for ≥48 hours are eligible. We will exclude patients with emergent PIVCs, known CHG allergy, skin injury at site of insertion or previous trial enrolment. Patients will be randomised to 3M Tegaderm Antimicrobial IV Advanced Securement dressing or standard care group. For the internal pilot, 300 patients will be enrolled to test protocol feasibility (eligibility, recruitment, retention, protocol fidelity, missing data and satisfaction of participants and staff), primary endpoint for internal pilot, assessed by independent data safety monitoring committee. Clinical outcomes will not be reviewed. Following feasibility assessment, the remaining 2624 (1312 per trial arm) patients will be enrolled following the same methods. The primary endpoint is a composite of catheter-related infectious complications and phlebitis. Recruitment began on 3 May 2023.

Ethics and dissemination

The protocol was approved by Ouest I ethic committee in France and by The Queensland Children’s Hospital Human Research Ethics Committee in Australia. The findings will be disseminated through presentation at scientific conferences and publication in peer-reviewed journals.

Trial registration number

NCT05741866
.
Cohort profile: The Obesity and Disease Development Sweden (ODDS) study, a pooled cohort
Authors: da Silva Marisa , Fritz Josef , Mboya Innocent B , Sun Ming , Wahlström Jens , van Guelpen Bethany , Michaëlsson Karl , Magnusson Patrik K E , Melander Olle , Sandin Sven , Yin Weiyao , Trolle Lagerros Ylva , Nwaru Bright , Leppert Jerzy , Chabok Abbas , Pedersen Nancy L , Elmståhl Sölve , Isaksson Karolin , Ingvar Christian , Hedman Linnea , Backman Helena , Häggström Christel , Stocks Tanja
Published: July 2024

Purpose

The Obesity and Disease Development Sweden (ODDS) study was designed to create a large cohort to study body mass index (BMI), waist circumference (WC) and changes in weight and WC, in relation to morbidity and mortality.

Participants

ODDS includes 4 295 859 individuals, 2 165 048 men and 2 130 811 women, in Swedish cohorts and national registers with information on weight assessed once (2 555 098 individuals) or more (1 740 761 individuals), in total constituting 7 733 901 weight assessments at the age of 17–103 years in 1963–2020 (recalled weight as of 1911). Information on WC is available in 152 089 men and 212 658 women, out of whom 108 795 have repeated information on WC (in total 512 273 assessments). Information on morbidity and mortality was retrieved from national registers, with follow-up until the end of 2019–2021, varying between the registers.

Findings to date

Among all weight assessments (of which 85% are objectively measured), the median year, age and BMI (IQR) is 1985 (1977–1994) in men and 2001 (1991–2010) in women, age 19 (18–40) years in men and 30 (26–36) years in women and BMI 22.9 (20.9–25.4) kg/m
2
in men and 23.2 (21.2–26.1) kg/m
2
in women. Normal weight (BMI 18.5–24.9 kg/m
2
) is present in 67% of assessments in men and 64% in women and obesity (BMI≥30 kg/m
2
) in 5% of assessments in men and 10% in women. The median (IQR) follow-up time from the first objectively measured or self-reported current weight assessment until emigration, death or end of follow-up is 31.4 (21.8–40.8) years in men and 19.6 (9.3–29.0) years in women. During follow-up, 283 244 men and 123 457 women died.

Future plans

The large sample size and long follow-up of the ODDS Study will provide robust results on anthropometric measures in relation to risk of common diseases and causes of deaths, and novel findings in subgroups and rarer outcomes.
Factors associated with the quality of corneas retrieved for transplantation by Eye Banks: a scoping review protocol
Authors: Mota Felipe Machado , Ferreira Júnior Marcos Antonio , Maidana Gustavo Moura , Cardoso Andréia Insabralde de Queiroz , Abes Bruna Dias , Dias Mayra , Meza Letícia Lima
Published: July 2024

Introduction

The cornea is an avascular and transparent layer of connective tissue crucial to retinal image quality. Diseases can impair its quality, affecting vision. Keratoplasty is the only therapy capable of restoring vision quality in severe corneal involvement. Despite the established practice of transplantation, access to corneal tissue is limited in many places, and the quality of retrieved corneas is not always adequate, resulting in disqualification. Not all factors affecting tissue quality are fully understood due to the multifactorial nature of processes and variations in procedures globally.

Objective

The objective is to map the global literature to establish the factors associated with the clinical and sociodemographic conditions of donors, and the conditions inherent in the processing of corneas that can influence the quality of this tissue for transplantation purposes.

Methods and analysis

A scoping review will be developed based on the methodological framework of the Joanna Briggs Institute. The scientific report will follow the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension checklist for Scoping Reviews. Searches will be conducted in 30 indexed and 12 grey literature databases, without time or location restrictions. The selection of studies will be carried out in three distinct phases: screening, eligibility and inclusion. After defining the sample, data from the selected studies will be systematically extracted into an electronic spreadsheet. The results will be presented descriptively through tables and graphs of absolute and relative frequency. In addition, the PRISMA Scoping Review flow chart will be presented to present the process of searching, including and excluding articles and documents.

Ethics and dissemination

This scoping review study does not require prior ethical approval as it uses publicly available and already published studies. The research protocol is registered in the Open Science Framework (osf.io/bw6r7). The findings will be submitted for publication in peer-reviewed scientific journals and presented at ophthalmology and/or transplantation conferences through oral presentations or posters.
Effects of individualised lung-protective ventilation with lung dynamic compliance-guided positive end-expiratory pressure titration on postoperative pulmonary complications of paediatric video-assisted thoracoscopic surgery: protocol for a randomised controlled trial
Authors: Chen Jiaxiang , Lin Rongmu , Shi Xiaoli , Liang Changsheng , Hu Wei , Ma Xinggang , Xu Liang
Published: July 2024

Introduction

Lung-protective ventilation strategies (LPVS) for one-lung ventilation (OLV) in paediatric patients pose greater challenges than in adults. Optimising LPVS for paediatric OLV to mitigate postoperative pulmonary complications (PPCs) has emerged as a current research focal point. However, there remains a divergence of opinions concerning the individualised setting and application of positive end-expiratory pressure (PEEP). Lung dynamic compliance (Cdyn) can serve as a reflection of the lung’s physiological state in children during OLV and is a readily obtainable parameter. This study protocol is formulated to assess the effectiveness of Cdyn-guided PEEP titration on PPCs during paediatric OLV.

Methods and analysis

This study constitutes a single-centre, prospective, double-blind, randomised controlled trial. The trial aims to recruit 60 paediatric patients scheduled for video-assisted thoracoscopic surgery. These eligible patients will be randomly assigned to either the Cdyn-guided PEEP group or the conventional PEEP group during general anaesthesia for OLV. The primary outcome will involve assessing the incidence of PPCs at 7 days after surgery. Secondary outcomes will encompass the evaluation of the modified lung ultrasound score following surgery, as well as monitoring the oxygenation index, driving pressure and Cdyn during mechanical ventilation. Data collection will be performed by investigators who are kept blinded to the interventions.

Ethics and dissemination

The Clinical Trial Ethics Committee at Shenzhen Children’s Hospital has conferred ethical approvals for this trial (approval number: 2022076). Results from this trial will be disseminated in peer-reviewed journals and presented at professional symposiums.

Trail registration number

NCT05386901.
Components of pharmacist-led medication reviews and their relationship to outcomes: a systematic review and narrative synthesis
Authors: Craske Miriam E. , Hardeman Wendy , Steel Nicholas , Twigg Michael J
Published: July 2024

Introduction

Pharmacist-led medication reviews are an established intervention to support patients prescribed multiple medicines or with complex medication regimes. For this systematic review, a medication review was defined as ‘a consultation between a pharmacist and a patient to review the patient’s total medicines use with a view to improve patient health outcomes and minimise medicines-related problems’. It is not known how varying approaches to medication reviews lead to different outcomes.

Aim

To explore the common themes associated with positive outcomes from pharmacist-led medication reviews.

Method

Randomised controlled trials of pharmacist-led medication reviews in adults aged 18 years and over were included. The search terms used in MEDLINE, EMBASE and Web of Science databases were “medication review”, “pharmacist”, “randomised controlled trial” and their synonyms, time filter 2015 to September 2023. Studies published before 2015 were identified from a previous systematic review. Risk of bias was assessed using the Cochrane risk of bias 2 tool. Descriptions of medication reviews’ components, implementation and outcomes were narratively synthesised to draw out common themes. Results are presented in tables.

Results

Sixty-eight papers describing 50 studies met the inclusion criteria. Common themes that emerged from synthesis include collaborative working which may help reduce medicines-related problems and the number of medicines prescribed; patient involvement in goal setting and action planning which may improve patients’ ability to take medicines as prescribed and help them achieve their treatment goals; additional support and follow-up, which may lead to improved blood pressure, diabetes control, quality of life and a reduction of medicines-related problems.

Conclusion

This systematic review identified common themes and components, for example, goal setting, action planning, additional support and follow-up, that may influence outcomes of pharmacist-led medication reviews. Researchers, health professionals and commissioners could use these for a comprehensive evaluation of medication review implementation.

PROSPERO registration number

CRD42020173907.
Chronic respiratory disease observatory for Africa (CHEST-Africa): study protocol for the prevalence, determinants and economic impacts of asthma and COPD in Africa
Authors: Ozoh Obianuju B , Ndimande Nqobile , Amaral Andre F S , Lesosky Maia , Mbonigaba Josue , Stolbrink Marie , Zurba Lindsey , Ayo-Olagunju Tochukwu , Kayembe-Kitenge Tony , Lakoh Suliaman , Mocumbi Ana , Mohammed Jibril , Nantanda Rebecca , Nunes Elizabete , Ouédraogo Abdoul Risgou , Owusu Sandra , Sibomana Jean Pierre , Masekela Refiloe , Mortimer Kevin
Published: July 2024

Introduction

Contemporary data on the burden of chronic respiratory diseases in sub-Saharan Africa is limited. More so, their economic burden is not well described. This study aims to establish a chronic respiratory disease observatory for Africa. Specific study aims are (1) to describe the prevalence and determinants of asthma with a target to screen up to 4000 children and adolescents across four African cities; (2) to determine the prevalence and determinants of chronic obstructive pulmonary disease (COPD) with a target to screen up to 3000 adults (≥18 years) across five African cities; (3) to describe the disease burden by assessing the frequency and severity of symptoms and exacerbations, medication use, emergency healthcare utilisation and hospitalisation; and (4) to assess the economic burden and affordability of the medicines for these diseases.

Methods and analysis

Surveys will be conducted in schools to identify children and adolescents with asthma using the Global Asthma Network screening questionnaire in Ghana, Nigeria, the Democratic Republic of Congo, and Uganda. Community surveys will be conducted among adults using an adapted version of the Burden of Obstructive Lung Disease Questionnaire to identify persons with COPD symptoms in Nigeria, Burkina Faso, Mozambique, Rwanda, and Sierra Leone. Fractional exhaled nitric oxide and pre-bronchodilator and post-bronchodilator spirometry will be done for children with asthma or asthma symptoms and for all adult participants. Children and adults with respiratory symptoms or diagnoses will complete the health economic questionnaires. Statistical analysis will involve descriptive and analytical statistics to determine outcomes.

Ethics and dissemination

Ethical approval has been obtained from participating institutions. This study’s results will inform deliberations at the United Nations General Assembly high-level meeting on non-communicable diseases in 2025. The results will be shared through academic conferences and journals and communicated to the schools and the communities.
Changes in male permanent contraception as partner access to long-acting reversible contraception (LARC) increases: an analysis of the National Survey for Family Growth, 2006–2010 versus 2017–2019
Authors: Beshar Isabel , So Jodi Y , Shaw Kate A , Cahill Erica P , Shaw Jonathan Glazer
Published: July 2024

Objective

Male permanent contraception (PC), that is, vasectomy, is an effective way of preventing pregnancy. In the United States, male PC use has historically been concentrated among higher-educated/higher-income males of White race. In the last decade, use of long-acting reversible contraception (LARC) has increased dramatically. We sought to understand how sociodemographic patterns of male PC have changed in the context of rising LARC use.

Study design

We examined the nationally representative male public use files of the National Survey for Family Growth (NSFG) across five survey waves. Our outcome was primary contraceptive use at last sexual encounter within 12 months. Using four-way multinomial logistic regressions (male PC, female PC, LARC, lower-efficacy methods), we compared sociodemographic factors predictive of male PC use versus reported partner LARC use between 2006–2010 (early) and 2017–2019 (recent) waves.

Results

We included 15 964 participants. From 2006 to 2019, there were absolute declines in male PC from 8.0% to 6.8%, while male-reported partner LARC use increased three-fold, from 3.4% to 11.0%. Among the highest economic strata, use of LARC converged with male PC. In adjusted analyses, high income significantly associated with male PC use in the early wave (OR 4.6 (1.4, 14.8)), but no longer in the recent wave (OR 0.9 (0.2, 4.2)). Marital status remained a significant but declining predictor of male PC across survey waves, and instead, by 2019, number of children newly emerged as the strongest predictor of male PC use.

Conclusion

Sociodemographic variables associated with vasectomy use are evolving, especially among high-income earners.
Haematoma block is the most efficient technique for closed forearm fracture reduction: a retrospective cohort study
Authors: Pitman Georgia Rose , Soeyland Torgrim , Popovic Gordana , Thomson David
Published: July 2024

Background

Forearm fractures are a common ED presentation. This study aimed to compare the resource utilisation of three anaesthetic techniques used for closed forearm fracture reduction in the ED: haematoma block (HB), Bier’s block (BB) and procedural sedation (PS).

Methods

A retrospective multicentre cohort study was conducted of adult patients presenting to either Port Macquarie Base Hospital ED or Kempsey District Hospital ED in New South Wales, Australia, from January 2018 to June 2021. Patients requiring a closed reduction in the ED were included. ED length of stay (LOS) was compared using a likelihood ratio test. Successful reduction on the first attempt and the number of ED specialists present for each method were both modelled with a linear regression. Staff utilisation by the level of training, cost of consumables and complications for each group were presented as descriptive statistics.

Results

A total of 226 forearm fractures were included. 84 used HB, 35 BB and 107 PS. The mean ED LOS was lowest for HB (187.7 min) compared with BB (227.2 min) and PS (239.3 min) (p=0.023). The number of ED specialists required for PS was higher when compared with HB and BB (p=0.001). The cost of consumables and a total number of staff were considerably lower for HB compared with PS and BB methods. PS had the highest proportion of successful reductions on the first attempt (94.4%) compared with BB (88.6%) and HB (76.2%) (p=0.006). More patients experienced complications from PS (17.8%) compared with BB (14.3%) and HB (13.1%).

Conclusions

In this study, the HB method was the most efficient as it was associated with a shorter ED LOS, lower cost and staff resource utilisation. Although PS had a significantly greater proportion of successful reductions on the first attempt, HB had fewer complications than BB and PS. EDs with limited resources should consider using HB or BB as the initial technique for fracture reduction with PS used for failed HB or when regional blocks are contraindicated.
Hepatitis E in men who have sex with men: a systematic review
Authors: Fitzpatrick Colin , Doherty Shaira , George Sabina , Richardson Daniel
Published: July 2024

Background

The transmission dynamics of hepatitis E in men who have sex with men (MSM) are poorly understood. We aimed to explore any factors observed in MSM with hepatitis E by systematically reviewing the literature.

Methods

We searched five databases (PubMed, Embase, CINAHL Plus, MEDLINE and Web of Science Core Collections). The primary author performed an initial screen of citations and abstracts, and two authors independently reviewed full-text manuscripts for eligibility. We only included manuscripts in English that explored at least one risk factor for hepatitis E. The risk of bias was assessed using the Joanna Briggs Institute toolkits. Narrative data were synthesised and tabulated. This review was registered on PROSPERO (ID: CRD42023472303).

Results

14 manuscripts were included in this review: two case reports, one case-control study, two cohort studies and nine cross-sectional studies from Italy (n=3), Japan (n=2), France (n=2), Argentina (n=1), Russia (n=1), the USA (n=1), the Netherlands (n=1), Belgium (n=1), Spain (n=1) and Greece (n=1). In total, there were 376 MSM with hepatitis E in this analysis. We have highlighted demographic (bimodal age (16–29 and >40), HIV pre-exposure prophylaxis use, living with HIV) and biological (previous syphilis, hepatitis C and hepatitis A) factors in MSM with previous/current hepatitis E. In five manuscripts, no association was found between MSM and hepatitis E.

Conclusion

Despite conflicting data, hepatitis E may be sexually transmissible in MSM, and MSM with unexplained jaundice, transaminitis, renal disease or neurological disease should be tested. HIV, hepatitis A (including vaccination), hepatitis C and syphilis testing are required in MSM with hepatitis E. This review provides some insight for future clinical guidelines, public health outbreak control strategies and research.
Geriatric trauma triage: optimizing systems for older adults—a publication of the American Association for the Surgery of Trauma Geriatric Trauma Committee
Authors: Egodage Tanya , Ho Vanessa P , Bongiovanni Tasce , Knight-Davis Jennifer , Adams Sasha D , Digiacomo Jody , Swezey Elisabeth , Posluszny Joseph , Ahmed Nasim , Prabhakaran Kartik , Ratnasekera Asanthi , Putnam Adin Tyler , Behbahaninia Milad , Hornor Melissa , Cohan Caitlin , Joseph Bellal
Published: July 2024

Background

Geriatric trauma patients are an increasing population of the United States (US), sustaining a high incidence of falls, and suffer greater morbidity and mortality to their younger counterparts. Significant variation and challenges exist to optimize outcomes for this cohort, while being mindful of available resources. This manuscript provides concise summary of locoregional and national practices, including relevant updates in the triage of geriatric trauma in an effort to synthesize the results and provide guidance for further investigation.

Methods

We conducted a review of geriatric triage in the United States (US) at multiple stages in the care of the older patient, evaluating existing literature and guidelines. Opportunities for improvement or standardization were identified.

Results

Opportunities for improved geriatric trauma triage exist in the pre-hospital setting, in the trauma bay, and continue after admission. They may include physiologic criteria, biochemical markers, radiologic criteria and even age. Recent Trauma Quality Improvement Program (TQIP) Best Practices Guidelines for Geriatric Trauma Management published in 2024 support these findings.

Conclusion

Trauma systems must adjust to provide optimal care for older adults. Further investigation is required to provide pertinent guidance.
Digitizing lattice gauge theories in the magnetic basis: reducing the breaking of the fundamental commutation relations
Authors: Romiti Simone , Urbach Carsten
Published: July 2024

We present a digitization scheme for the lattice $${\textrm{SU}}(2)$$

SU
(
2
)

gauge theory Hamiltonian in the magnetic basis, where the gauge links are unitary and diagonal. The digitization is obtained from a particular partitioning of the $${\textrm{SU}}(2)$$

SU
(
2
)

group manifold, with the canonical momenta constructed by an approximation of the Lie derivatives on this partitioning. This construction, analogous to a discrete Fourier transform, preserves the spectrum of the electric part of the Hamiltonian and the canonical commutation relations exactly on a subspace of the truncated Hilbert space, while the residual subspace can be projected above the cutoff of the theory.