bluuebunny/crossref_metadata_2025_split huggingface dataset:
Protein status of people with phenylketonuria: a scoping review protocol
Authors: Firman Sarah , Ramachandran Radha , Whelan Kevin , Witard Oliver C , O’Keeffe Majella 
Published: September 2021

IntroductionPhenylketonuria (PKU) is a disorder of protein metabolism resulting in an accumulation of phenylalanine in the body. Dietary management consists of altering the sources of ingested protein to limit phenylalanine intake. Current dietary protein guidelines for PKU are based on limited scientific evidence, thus it remains unclear whether current practice leads to optimal protein status in people with PKU. To date, no attempt has been made to systematically evaluate the protein status of people with PKU, using a combination of validated anthropometric, biochemical and functional measurement tools. Furthermore, factors known to influence protein status in the general population warrant consideration when determining protein status in individuals with PKU, alongside factors unique to PKU such as the type of protein substitute consumed. Understanding the impact of these variables on protein status is crucial to developing a personalised approach to protein recommendations for optimising health and functional outcomes in people with PKU. Therefore, the aim of this scoping review is to examine existing evidence regarding the protein status of people with PKU, and to investigate the nutritional and lifestyle variables that influence protein status.Methods and analysisThis review will be guided by Arksey and O’Malley’s framework, along with guidance from Levacet al, Pawliuket aland the Joanna Briggs Institute. The following databases will be searched: MEDLINE (Ovid), Embase, CENTRAL, Web of Science and Scopus, alongside grey literature. Identified literature will be assessed by two independent reviewers for inclusion. Descriptive numerical analysis will be performed and a narrative summary will accompany the tabulated results describing how study findings relate to the review questions.Ethics and disseminationThis review protocol does not require ethical approval. Findings will be disseminated through peer-reviewed publication, presented at relevant conferences, and shared with a patient research advisory group to inform discussions on future research.
Prevalence, duration of exposure and predicting factors for snus use among young Finnish men: a cross-sectional study
Authors: Danielsson Maria , Tanner Tarja , Patinen Pertti , Birkhed Dowen , Anttonen Vuokko , Lammi Anelma , Siitonen Simo , Ollgren Jukka , Pylkkänen Liisa , Vasankari Tuula 
Published: September 2021

ObjectiveThe health hazards of tobacco products depend on the level of exposure, but little is known about the characteristics of snus use. The aim of this study was to investigate the duration of daily exposure to snus among occasional and daily users and its associated predictive factors among young Finnish men.DesignCross-sectional questionnaire study.SettingThree out of 16 Finnish Defence Forces units.Participants1280 young Finnish male conscripts starting their military service in 2016 chosen by simple random sampling.Primary and secondary measuresThe prevalence, duration of use and the amount of daily usage of snus and cigarettes were investigated. The attitudes towards perceived harmfulness of snus and the predictive factors affecting the total time of snus consumption were examined.ResultsAlmost a fifth (19.5%) of the conscripts reported daily snus use, and a further 16% reported occasional use. Daily snus use was associated with an earlier starting age, longer duration of use and higher daily exposure time compared with occasional use. On average, daily snus users consumed 10 portions and occasional users three portions per day (p<0.001). The daily total exposure time for daily users was 372 min (95% CI 344 to 401) and for occasional users 139 min (95% CI 106 to 171). Respondents with an upper secondary education had significantly less daily total exposure than those with basic comprehensive education (p=0.036). Perceptions of snus as a harmful substance resulted in a significantly lower duration of exposure.ConclusionSnus use was very common among young Finnish men. High snus exposure duration was associated with an earlier starting age, a longer history of use and a careless attitude to its health hazards. A higher education level was a protective factor for total exposure time. Studies of the long-term health effects and dependency profile of snus use are needed.
Evaluating associations of joint swelling, joint stiffness and joint pain with physical activity in first-degree relatives of patients with rheumatoid arthritis: Studies of the Aetiology of Rheumatoid Arthritis (SERA), a prospective cohort study
Authors: Hughes-Austin Jan M , Ix Joachim H , Ward Samuel R , Weisman Michael H , ODell James R , Mikuls Ted R , Buckner Jane H , Gregersen Peter K , Keating Richard M , Demoruelle M Kristen , Deane Kevin D , Holers V Michael , Norris Jill M 
Published: September 2021

ObjectivePhysical activity (PA) in preclinical rheumatoid arthritis (RA) is associated with lower RA risk and disease severity. As joint signs and symptoms of inflammatory arthritis serve as a barrier to PA in RA, it is important to consider whether they affect PA in the time prior to RA. Therefore, we investigated whether joint swelling, stiffness or pain were associated with PA in first-degree relatives (FDRs) of patients with RA, a population at higher risk for future RA.DesignProspective study design.SettingWe recruited FDRs of patients with RA from academic centres, Veterans’ hospitals and rheumatology clinics or through responses to advertising from six sites across the USA.ParticipantsWe evaluated associations of joint stiffness, joint swelling and joint pain with PA time in 268 FDRs with ≥2 visits over an average 1.2 years. Clinicians confirmed joint swelling. Participants self-reported joint stiffness and/or pain.Primary outcome measuresPA during a typical 24-hour day was quantified via questionnaire, weighted to reflect metabolic expenditure, where 24 hours was the minimum PA time. Linear mixed models evaluated associations between symptoms and change in PA over time, adjusting for age, sex, race, body mass index, smoking and RA-related autoantibodies.ResultsAverage weighted PA time was 37±7 hours. In the cross-sectional analysis, PA time was 1.3±0.9 hours higher in FDRs reporting joint pain (p=0.15); and 0.8±1.6 and 0.4±1 hours lower in FDRs with joint swelling (p=0.60) and stiffness (p=0.69), respectively. Longitudinally, adjusting for baseline PA time, baseline symptoms were not significantly associated with changes in PA time. However, on average over time, joint stiffness and pain were associated with lower PA time (pinteraction=0.0002, pinteraction=0.002), and joint swelling was associated with higher PA time (pinteraction<0.0001).ConclusionBaseline symptoms did not predict future PA time, but on average over time, joint symptoms influenced PA time.
Development of a culturally and linguistically sensitive virtual reality educational platform to improve vaccine acceptance within a refugee population: the SHIFA community engagement-public health innovation programme
Authors: Streuli Samantha , Ibrahim Najla , Mohamed Alia , Sharma Manupriya , Esmailian Markie , Sezan Ibrahim , Farrell Carrie , Sawyer Mark , Meyer Dan , El-Maleh Khaled , Thamman Ritu , Marchetti Alex , Lincoln Alan , Courchesne Eric , Sahid Ahmed , Bhavnani Sanjeev P 
Published: September 2021

ObjectivesTo combat misinformation, engender trust and increase health literacy, we developed a culturally and linguistically appropriate virtual reality (VR) vaccination education platform using community-engaged approaches within a Somali refugee community.DesignCommunity-based participatory research (CBPR) methods including focus group discussions, interviews, and surveys were conducted with Somali community members and expert advisors to design the educational content. Co-design approaches with community input were employed in a phased approach to develop the VR storyline.Participants60 adult Somali refugees and seven expert advisors who specialise in healthcare, autism research, technology development and community engagement.SettingSomali refugees participated at the offices of a community-based organisation, Somali Family Service, in San Diego, California and online. Expert advisors responded to surveys virtually.ResultsWe find that a CBPR approach can be effectively used for the co-design of a VR educational programme. Additionally, cultural and linguistic sensitivities can be incorporated within a VR educational programme and are essential factors for effective community engagement. Finally, effective VR utilisation requires flexibility so that it can be used among community members with varying levels of health and technology literacy.ConclusionWe describe using community co-design to create a culturally and linguistically sensitive VR experience promoting vaccination within a refugee community. Our approach to VR development incorporated community members at each step of the process. Our methodology is potentially applicable to other populations where cultural sensitivities and language are common health education barriers.
Attitudes of Chinese immigrants in Canada towards the use of Traditional Chinese Medicine for prevention and management of COVID-19: a cross-sectional survey during the early stages of the pandemic
Authors: Kong Yujia , Shaver Lance Garrett , Shi Fuyan , Yang Lixia , Zhang Weiguo , Wei Xiaolin , Zhu Yun , Wang Yiran , Wang Peizhong Peter 
Published: September 2021

ObjectionThe objective of this study was to assess attitudes towards the use of Traditional Chinese Medicine (TCM) for COVID-19 among Chinese immigrants in Canada during the early stage of the COVID-19 pandemic.MethodsA cross-sectional study was conducted in April 2020 in Canada. Individuals aged 16 or older who were of Chinese origin and living in Canada at the time of the survey were invited to participate in an online survey. Descriptive and univariate statistics were performed to describe participant attitudes towards various preventive and treatment measures for COVID-19. Multiple logistic regression was used to identify independent associations with sociodemographic factors and attitudes.ResultsA total of 754 eligible respondents were included in the analysis. 65.8% of the participants were female, 77.2% had a university degree or higher and 28.6% were 55 years of age or older. Overall, 48.8% of the study participants believed that TCM was effective in preventing COVID-19% and 46.2% would use TCM if they had COVID-19-related symptoms. However, the corresponding numbers for western medicine were 20.8% and 39.9%, which were statistically lower (p<0.01). Older participants (55+vs <35, OR=3.55 (95% CI 2.05 to 6.14); 35–54 vs <35, OR=1.98 (95% CI 1.27 to 3.08)) and those who were dissatisfied with their income (OR=2.47(95% CI 1.56 to 3.92)) were more likely to believe TCM was effective against COVID-19. Similarly, older participants (55+vs <35, OR=3.13 (95% CI 1.79 to 5.46); 35–54 vs <35, OR=2.25 (95% CI 1.35 to 3.74)), females (OR=1.60 (95% CI 1.15 to 2.23)), and those born in mainland China (OR=10.49 (95% CI 2.32 to 47.39)) were more likely to use TCM if they had symptoms of COVID-19.ConclusionDespite the lack of scientific evidence to support its use, TCM was widely believed by Chinese immigrants in Canada to be an effective means of preventing COVID-19 and many also stated they would use it if they were experiencing symptoms of COVID-19.
Risk of out-of-hospital cardiac arrest among sepsis survivors in Taiwan: analysis of a nationwide population-based cohort
Authors: Hsu Wan-Ting , Sherrod Charles Fox , Tehrani Babak , Papaila Alexa , Porta Lorenzo , Hsu Tzu-Chun , Sheng Wang-Huei , Lee Chien-Chang 
Published: September 2021

ObjectivesThere is minimal literature examining the association of sepsis with out-of-hospital cardiac arrest (OHCA). Using a large national database, we aimed to quantify the risk of OHCA among sepsis patients after hospital discharge.DesignPopulation-based cohort study.SettingNationwide sepsis cohort retrieved from the National Health Insurance Research Database of Taiwan between 2000 and 2013.ParticipantsWe included 17 304 patients with sepsis. After hospital discharge, 144 patients developed OHCA within 30 days and 640 between days 31 and 365.Primary and secondary outcome measuresThe main outcomes were OHCA events following hospital discharge for sepsis. To evaluate the independent association between sepsis and OHCA after a sepsis hospitalisation, we constructed two non-sepsis comparison cohorts using risk set sampling and propensity score matching techniques (non-infection cohort, non-sepsis infection cohort). We plotted the daily number and daily risk of OHCA within 1 year of hospital discharge between sepsis and matched non-sepsis cohorts. We used Cox regression to evaluate the risk of early and late OHCA, comparing sepsis to non-sepsis patients.ResultsCompared with non-infected patients, sepsis patients had a higher rate of early (HR 1.66, 95% CI: 1.27 to 2.16) and late (HR 1.19, 95% CI: 1.06 to 1.33) OHCA events. This association was independent of age, sex or cardiovascular history. Compared with non-sepsis patients with infections, sepsis patients had a higher rate of both early (HR 1.28, 95% CI: 1.00 to 1.63) and late (HR 1.13, 95% CI: 1.01 to 1.27) OHCA events, especially among patients with cardiovascular disease (OR 1.35, 95% CI: 1.01 to 1.81).ConclusionsSepsis patients had increased risk of OHCA compared with matched non-sepsis controls, which lasted up to 1 year after hospital discharge.
European knowledge alliance for innovative measures in prevention of work-related musculoskeletal pain disorders (Prevent4Work Project): protocol for an international mixed-methods longitudinal study
Authors: Bellosta-López Pablo , Domenech-Garcia Victor , Palsson Thorvaldur Skuli , Christensen Steffan Wittrup , Silva Priscila de Brito , Langella Francesco , Berjano Pedro , Jensen Palle Schlott , Riis Allan , Baroncini Alice , Blasco-Abadía Julia , Jiménez-Sánchez Carolina , Calvo Sandra , Jaén-Carrillo Diego , Herrero Pablo , Hoegh Morten 
Published: September 2021

IntroductionWork-related musculoskeletal (MSK) pain is a highly prevalent condition and one of the main contributors to disability and loss of work capacity. Current approaches to the management and prevention of work-related MSK pain do not consistently integrate current evidence-based knowledge and seem to be outdated. The Prevent4Work (P4W) Project aims to collect and spread evidence-based information to improve the management and prevention of work-related MSK pain. P4W will longitudinally investigate (1) risk factors associated with the prevalence of work-related MSK pain, (2) predictive factors for new events of work-related MSK pain in the short term and (3) the modification of pain beliefs after participating in evidence-based e-learning courses.Methods and analysisThis project employs a mixed-methods design with international cohorts of workers from Spain, Italy and Denmark. All participants will be assessed using self-reported variables at baseline (ie, cross-sectional design) with follow-up after 3 and 6 months (ie, prospective–predictive design). Throughout the first phase (0–3 months), all participants will be offered to self-enrol in e-learning courses on work-related MSK pain. Changes in pain beliefs (if any) will be assessed. The dataset will include sociodemographic characteristics, physical and psychological job demands, lifestyle-related factors, MSK pain history and pain beliefs. At baseline, all participants will additionally complete the P4W questionnaire developed to detect populations at high risk of suffering work-related MSK pain.Descriptive statistics, binary logistic regression, and analysis of variance will be used to identify the significant factors that influence the history of work-related MSK pain, evaluate the short-term prediction capacity of the P4W questionnaire, and investigate whether workers’ participation in e-learning courses will modify their pain beliefs.Ethics and disseminationThe study received ethical approval from the Ethical Committee of San Jorge University (USJ011-19/20). The results will be made available via peer-reviewed publications, international conferences and P4W official channels.
Using social networks to scale up and sustain community-based programmes to improve physical activity and diet in low-income and middle-income countries: a scoping review protocol
Authors: Abrahams Nina , Lambert Estelle V , Marais Frederick , Toumpakari Zoi , Foster Charlie 
Published: September 2021

IntroductionThe World Health Organisation endorses community-based programmes as a cost-effective, feasible and a ‘best buy’ in the prevention and management of non-communicable diseases (NCDs). These programmes are particularly successful when the community actively participates in its design, implementation and evaluation. However, they may be only useful insofar as they can be scaled up and sustained in some meaningful way. Social network research may serve as an important tool for determining the underlying mechanisms that contribute to this process. The aim of this planned scoping review is to map and collate literature on the role of social networks in scaling-up and sustaining community-based physical activity and diet programmes in low-income and middle-income countries.Methods and analysisThis scoping review protocol has been planned around the Arksey and O"Malley framework and its enhancement. Inclusion criteria are peer-reviewed articles and grey literature exploring the role of social networks in the scale-up and/or sustainability of NCD prevention community-based programmes in adult populations. Studies must have been published since 2000, in English, and be based in a low-income or middle-income country. The following databases will be used for this review: PubMed, Cochrane, Scopus, Web of Science, CINAHL, SocIndex, the International Bibliography of the Social Sciences, Google and Google Scholar. Books, conference abstracts and research focused only on children will be excluded. Two reviewers will independently select and extract eligible studies. Included publications will be thematically analysed using the Framework Approach.Ethics and disseminationEthical approval will not be sought for this review as no individual-level data or human participants will be involved. This protocol is registered on the Open Science Framework (https://doi.org/10.17605/OSF.IO/KG7TX). The findings from the review will be published in an accredited journal. The Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews checklist will be used to support transparency and guide translation of the review.
Opioid and healthcare service use in medical cannabis patients with chronic pain: a prospective study
Authors: Sznitman Sharon , Mabouk Carolyn , Said Zahi , Vulfsons Simon 
Published: September 2021

BackgroundVarious jurisdictions have legalised medical cannabis (MC) for use in chronic pain treatment. The objective of this study was to determine if the use of MC is related to a reduction in the use of prescription opioids and other prescription medications and healthcare services.MethodsA retrospective cohort study was conducted using the medical files of 68 Israeli patients with chronic pain using MC. Number of prescription medications filled and healthcare services used were recorded separately for the baseline period (6 months prior to the start of MC treatment) and 6 months’ follow-up. Paired t-tests were used to compare each individual to himself/herself from baseline to follow-up.ResultsPatients filled less opioid prescription medication at follow-up compared with baseline, and the reduction was of small effect size. There were no significant changes in the use of other medications or use of healthcare services from pre-MC treatment to follow-up.ConclusionsMC may be related to a significant yet small reduction in opioid prescription medication. Further prospective studies with representative samples are warranted to confirm the potential small opioid-sparing effects of MC treatment, its clinical importance, if any, and potential lack of association with other healthcare-related services and medication use. Due to methodological limitations of the data used in this study, results may be regarded as preliminary and causal inferences cannot be made.
Using genetics to detangle the relationships between red cell distribution width and cardiovascular diseases: a unique role for body mass index
Authors: Thayer Timothy E , Huang Shi , Farber-Eger Eric , Beckman Joshua A , Brittain Evan L , Mosley Jonathan D , Wells Quinn S 
Published: September 2021

ObjectiveRed cell distribution width (RDW) is an enigmatic biomarker associated with the presence and severity of multiple cardiovascular diseases (CVDs). It is unclear whether elevated RDW contributes to, results from, or is pleiotropically related to CVDs. We used contemporary genetic techniques to probe for evidence of aetiological associations between RDW, CVDs, and CVD risk factors.MethodsUsing an electronic health record (EHR)-based cohort, we built and deployed a genetic risk score (GRS) for RDW to test for shared genetic architecture between RDW and the cardiovascular phenome. We also created GRSs for common CVDs (coronary artery disease, heart failure, atrial fibrillation, peripheral arterial disease, venous thromboembolism) and CVD risk factors (body mass index (BMI), low-density lipoprotein, high-density lipoprotein, systolic blood pressure, diastolic blood pressure, serum triglycerides, estimated glomerular filtration rate, diabetes mellitus) to test each for association with RDW. Significant GRS associations were further interrogated by two-sample Mendelian randomisation (MR). In a separate EHR-based cohort, RDW values from 1-year pre-gastric bypass surgery and 1–2 years post-gastric bypass surgery were compared.ResultsIn a cohort of 17 937 subjects, there were no significant associations between the RDW GRS and CVDs. Of the CVDs and CVD risk factors, only genetically predicted BMI was associated with RDW. In subsequent analyses, BMI was associated with RDW by multiple MR methods. In subjects undergoing bariatric surgery, RDW decreased postsurgery and followed a linear relationship with BMI change.ConclusionsRDW is unlikely to be aetiologically upstream or downstream of CVDs or CVD risk factors except for BMI. Genetic and clinical association analyses support an aetiological relationship between BMI and RDW.